Epistaxis: Diagnostic Approach to Common and Uncommon Causes

Congress:

ECR 2020

Poster Number:

C-05136

Type:

Educational Exhibit

Keywords:

Multicentre study, Not applicable, Neoplasia, Haematologic diseases, Foreign bodies, Imaging sequences, Diagnostic procedure, PET-CT, MR-Diffusion/Perfusion, CT-High Resolution, Vascular, Head and neck, Anatomy, Head and Neck

Authors:

E. Marín Diez¹, S. Strauss², E. YLLERA CONTRERAS³, E. M. Marco De Lucas⁴, C. D. Phillips²; ¹Santander/ES, ²New York/US, ³BURGOS/ES, ⁴Santander, Ca/ES

DOI:

10.26044/ecr2020/C-05136

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-05136

Fig. 2: Anatomy: illustrations and angiograms.

Fig. 3: Etiologic factors of epistaxis.

Fig. 4: Foreign bodies.

Learning objectives

Anatomical considerationsin the ontogenesis of epistaxis: Angiograms and illustrations. Image-based reviewof both common and uncommon causes of epistaxis.

Background

EPIDEMIOLOGY Epistaxis isone of the most common emergenciesin the ear, nose, and throat (ENT) department. Epistaxis presents abimodal age distribution, affecting individuals aged 2-10 years and aged 50-80 years. Peak incidence occurs among patients older than 70. Epistaxis may induce significant morbidity, particularly in the elderly and those with coexisting cardiovascular disease. ANATOMY Arterial Anatomy Relevant to Epistaxis ECA branches: Internal maxillary artery --> Sphenopalatine and Greater palatine arteries. Facial artery --> Superior labial artery. ICA branches: Ophthalmic artery --> Anterior and Posterior ethmoidal arteries....

Findings and procedure details

RADIOLOGICAL EVALUATION OF EPISTAXIS Fig. 3 IMAGE-BASED REVIEW A.TRAUMA Local traumato the nasal mucosa is a common cause of epistaxis, especially among the pediatric population. The most common cause of epistaxis is trauma from digital manipulation. Children may present with epistaxis after digital trauma or local irritation from foreign bodies. Other sources of local trauma: nasal or facial bone fractures, foreign body insertion, septal perforation from substance abuse, and iatrogenic trauma (from surgery or placement of appliances). Fig. 4 Fig. 5 Fig. 6 Fig. 7...

Conclusion

Arterial anatomy of the nasal passagesis important to understanding and identifying causes of secondary epistaxis. Thedifferential diagnosis of causes of epistaxis is vastand encompasses a wide range of etiologic factors, ranging from benign causes, such as digital trauma and foreign bodies, to life-altering entities, including systemic hematologic disorders, locally destructive tumors, andsinonasalmalignancies. Patient age and comorbiditiesare important considerationswhen assessing underlying cause of epistaxis.

Personal information and conflict of interest

E. Marín Díez; Santander/ES - nothing to disclose S. Strauss; New York/US - nothing to disclose C. D. Phillips; New York/US - nothing to disclose E. M. Marco de Lucas; Santander, CA/ES - nothing to disclose E. Yllera Contreras; Burgos/ES - nothing to disclose

References

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