Clinical Case Database / Category: Clinical Care

Recurrent unilateral epistaxis

Publication details

Andrea Pisesky MBBS, Sonna Ifeacho DOHNS MRCS, Abir K Bhattacharyya MS FRCS FACS FRCS(ORL)
Foundation Years Journal, volume 7, issue 1, p.6 (123Doc Education, London, January 2013)


Epistaxis is a common medical complaint. Although the exact incidence is unknown, it is thought to occur in 60% of people at some point in their life, 6% of which will seek medical advice (1). Epistaxis can occur in all age ranges, from children through to the elderly. The spectrum of clinical manifestation extends from mild intermittent blood-stained rhinorrhoea to life threatening haemorrhage. Local and systemic factors can contribute to the aetiology of epistaxis. Many cases of epistaxis can be controlled by local measures, such as pinching the nostrils and ice packs to the head. However, some cases require nasal cautery, packing or surgical ligation or radiological embolisation of arteries. We present a case of a 79-year old gentleman with an acute presentation of recurrent unilateral epistaxis. It is essential to speedily elicit a clear history. After appropriate resuscitation, endoscopic examination allows identification of responsible vessel and effective management.

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Andrea Pisesky MBBS

Foundation Year Trainee
Department of ENT
Whipps Cross University Hospital
Whipps Cross Road, Leytonstone
London E11 1NR

Sonna Ifeacho DOHNS MRCS

Specialist Registrar in ENT
Department of ENT
Whipps Cross University Hospital
Whipps Cross Road, Leytonstone
London E11 1NR

Abir K Bhattacharyya MS FRCS FACS FRCS(ORL) (Corresponding author)

Consultant ENT Surgeon & Royal College Surgical Tutor
Department of ENT
Whipps Cross University Hospital
Whipps Cross Road, Leytonstone
London E11 1NR


1. Viehweg TL, Roberson JB, Hudson JW. Epistaxis: diagnosis and treatment. J Oral Maxillofac Surg 2006;64:511-518
2. Rodney J. Schlosser, M.D. Epistaxis. New England Journal of Medicine 2009; 360:784-789


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