Nasal bleeding (epistaxis), also known as epistaxis, is a common clinical symptom, mostly caused by nasal lesions, but can also be caused by systemic diseases, and occasionally bleeding through the nasal cavity due to adjacent nasal lesions. Rhinorrhea is mostly unilateral or bilateral; most of the bleeding can be stopped by itself. The amount of bleeding varies, from blood in nasal discharge in mild cases to hemorrhagic shock in severe cases; repeated bleeding can lead to anemia.
There are various causes of nasal bleeding.
Local causes: ① traumatic impact on the nose or digging too deep or too heavy; ② curved nasal septum or crest or talus, because the local mucosa is thin, easy to bleed after air stimulation; ③ acute rhinitis, atrophic rhinitis is easy to bleed; ④ a few cases are caused by nasal cavity, sinus or nasopharyngeal tumor bleeding, such as hemangioma, nasopharyngeal cancer, sinus cancer.
Systemic causes: ① high arterial pressure, such as hypertension, arteriosclerosis, cerebral hemorrhage, etc.; ② elevated venous pressure, such as mitral stenosis, pulmonary edema, etc.; ③ acute febrile infectious diseases, such as upper respiratory tract infection, influenza, etc.; ④ blood disorders, such as leukemia, hemophilia, various purpura, etc.; ⑤ liver and spleen disorders and rheumatism; ⑥ phosphorus, arsenic and benzene poisoning can damage the function of the hematopoietic system and cause bleeding; ⑦ compensatory menses .
Symptoms Bleeding can occur in any part of the nasal cavity, but is most common in the anterior inferior nasal septum, and is sometimes seen as jet or pulsatile small arterial bleeding. The posterior nasal bleeding often flows rapidly into the pharynx and is spit out of the mouth. Generally speaking, nasal bleeding caused by local disorders is mostly limited to one nasal cavity, while those caused by systemic diseases may bleed alternately or simultaneously in both nasal cavities.
If the bleeding is not severe, posterior rhinoscopy or fiberoptic nasopharyngoscopy is feasible. Bleeding in the sinuses, blood often flows from the nasal passage or olfactory fissure. In addition to finding the bleeding site, and make the necessary systemic examination (measurement of blood pressure, routine blood tests, determination of bleeding time and clotting time, capillary fragility test and platelet count, etc.). In some cases, a joint consultation with relevant departments is required to find the cause.