Classification of epistaxis
Epistaxis is usually classified into two types:
- anterior bleeding
- more common - seen in around 90% of cases
- occurs in the anterior septal area which is supplied by Keisselbach’s plexus in a site known as the Little’s area
- Kiesselbach's plexus is supplied by both external and internal carotid artery branches
- is clinically obvious
- posterior bleeding
- present in around 10% of cases
- usually arises in the posterior nasal cavity at the following sites
- behind the posterior part of the middle turbinate
- the posterior superior roof of the nasal cavity
- involves branches of the sphenopalatine arteries which forms part of the Woodruff plexus
- sometimes involves large vessels resulting in sudden massive bleeding
- may be subtle or may present with an insidious onset as hematemesis, nausea, anaemia, haemoptysis or melaena
- more common in older patients
Reference
- Mulla O, Prowse S, Sanders T, et al; Epistaxis. BMJ. 2012 Feb 23;344
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