Epistaxis in the University of Port Harcourt Teaching Hospital: Aetiological Profile and Management

Abstract

Background: Bleeding from the nose is one of the commonest emergencies that could present in a typical ear, nose and throat clinic. It is often a frightful experience for both the patient and relations, especially in severe cases. Aim: To determine the aetiological profile, the management and outcome in patients that presented with epistaxis in University of Port Harcourt teaching hospital.  Patients and Methods: This was a retrospective study of patients with complaints of epistaxis that were managed within the period of January 2006 to January 2018 in the Ear, Nose and Throat (ENT) department, including referrals from the accident & emergency department and children emergency ward. Data on demographics, aetiology, associated clinical features, treatment modalities and outcome of such treatments were all collated. These were analyzed using IBM statistical package for social sciences SPSSversion 20and results presented in simple descriptive tables. Results: There were altogether 196 patients studied, 95 males and 101 females, giving a male to female ratio of 1:1.06.  The age range was from 1 to 81 years. Age group 30-39 was the most affected with 22.29% Aetiological factors were; hypertension in 9.2% trauma in 11.2%, idiopathic in most; 58.2%, chronic rhinosinusitis in 18.4%. Conservative medical therapy was the commonest treatment modality; 68.38%. Anterior nasal packing in 26.5% while 4.1% had posterior packing. Anterior aspect of the nose was the commonest site of bleed recorded in 160 cases. All the patients had a favourable outcome. Conclusion: Epistaxis in this environment still presents as a common emergency and in the majority of the case, the cause is not known, however, trauma appears to be one of the commonest cause implicated in our setting. The young adults appear to be the ones mainly affected.