Protocolo diagnóstico y terapéutico de la epistaxis

  1. F.J. Gamboa 1
  2. C. Charles 1
  3. T. Rivera 1
  1. 1 Hospital Universitario Príncipe de Asturias. Universidad de Alcalá
Revue:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Année de publication: 2015

Titre de la publication: Patología oftálmica y otorrinolaringologíca

Serie: 11

Número: 91

Pages: 5462-5466

Type: Article

DOI: 10.1016/J.MED.2015.11.017 DIALNET GOOGLE SCHOLAR

D'autres publications dans: Medicine: Programa de Formación Médica Continuada Acreditado

Résumé

Epistaxis arise more often in the Kisselbach's submucous arterial plexus, which is located at both sides in the anterior part of the nasal septum. Significantly less often, the pinpoint bleeding is in the back of the nostril, normally in a zone irrigated by the Sphenopalatine artery that leads to the posterolateral side of the nostril by the hole of the same name. Anterior epistaxis, that can be self-limiting, usually are controlled by simple manoeuvres as cauterizing the bleeding vessel or anterior packing. However, epistaxis originated at the back of the nostril often occur in middle-aged or elderly patients, with associated pathology. In posterior epistaxis cases, they usually require the placement of a pneumo-packing and, possibily, endoscopic cauterizing or clipping under general anaesthesia of the bleeding vessel, placing frequently a conventional posterior packing. Some cases are resolved by arterial embolization.

Références bibliographiques

  • García S, Baixauli A. Guía clínica de epistaxis. Fisterra.com. Atención primaria en la red. Madrid: Elsevier; 2015.
  • Kasperek ZA, Pollock GF. Epistaxis: an overview. Emerg Med Clin N Am. 2013;31:443-54.
  • Barnes ML, Spielmann PM, White PS. A Contemporary eviden-ce based approach. Otolaryngol Clin N Am. 2012;45:1005-17.
  • Morgan DJ, Kellerman R. Epistaxis: evaluation and treatment. Prim Care Clin Office Pract. 2014;41:63-73.
  • García Callejo FJ, Muñoz Fernández N, Achiques Martínez MT, Frías Moya-Angeler S, Montoro Elena MJ, Algarra JM. Nasal packing in pos-terior epistaxis. Comparison of two methods. Acta Otorrinolaringol Esp. 2010;61(3):196.