Epistaxis classification On the Web
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Epistaxis may be classified according to the anatomical origin of the bleeding into 2 groups: anterior and posterior. It can also be further classified into primary (if idiopathic) or secondary (if there is a known cause) and acute or chronic.
Classification according to anatomical source
- Anterior epistaxis is more common, and source of this bleeding is usually Kiesselbach's plexus.
- Anterior epistaxis is easier to control with nasal compression, nasal packing and cautery.
- Posterior bleeding is less common and harder to stop, and source of this bleeding is usually Woodruff's plexus.
- Woodruff's plexus is formed by vessels that are branches of the external carotid artery, thus, when it bleeds, it is usually much more severe than bleeding from Kiesselbach plexus' bleeding.
- Bleeding from this plexus may cause aspiration and show bleeding with coughing and hemoptysis.
- This type of bleeding is more common in patients taking anticoagulants or hypertension.
Classification according to time
- Chronic epistaxis : it is characterized by intermittent bleeding, that persists through a period of time.
Classification according to etiology
- Secondary: it is classified as secondary if the bleeding is caused by another disease process (trauma, anticoagulants, arterial malformation).
- Krulewitz, Neil Alexander; Fix, Megan Leigh (2019). "Epistaxis". Emergency Medicine Clinics of North America. 37 (1): 29–39. doi:10.1016/j.emc.2018.09.005. ISSN 0733-8627.
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- "StatPearls". 2020. PMID 28613768.