Clinical and Laboratory Characteristics of Pediatric Epistaxis Presenting to the Pediatric Emergency Department
Abstract
Objective: The aim of this study was to review our institutional experience with the clinical characteristics, laboratory findings, and therapies in children with epistaxis and comparing them with the literature.
Material and Methods: Clinical and laboratory findings of 538 children with epistaxis, admitted at our pediatric emergency department from January 2018 to December 2018, were retrospectively evaluated.
Results: The study group included 538 children diagnosed with epistaxis. 321 (59.66%) patients were male and 217 (40.33%) were female. The mean age at admission was 9.0±4.7 years. The most common cause was idiopathic. It was more common in the spring months (40.66%). There was no history of chronic disease in 532 (98.88%) of patients and drug use in 517 (96.09%). Of the 538 patients, initial treatment consisted of nasal cautery (7), nasal packing (3), local pomad (69), or no treatment (420).
Conclusion: This study demonstrated that the most common cause of epistaxis in children is idiopathic. Unlike adults, the underlying systemic disease is rare in children. Epistaxis is controlled with conservative measures in the majority of cases
References
- 1. Özcan C. Epistaksis. İçinde: Koç C, editör. Kulak Burun Boğaz Hastalıkları ve Baş Boyun Cerrahisi. Birinci Baskı, Ankara, Güneş Kitabevi, 2004: 479-93.
- 2. Brown NJ, Berkowitz RG. Epistaxis in healthy children requiring hospital admission. Int J Pediatr Otorhinolaryngol 2004;68:1181-4.
- 3. Gifford TO, Orlandi RR. Epistaxis. Otolaryngol Clin North Am 2008;41:525-36.
- 4. Al Khtoum N, Al Roosan M. The evaluation of conservative measures in the treatment of epistaxis. Khartoum Med J 2008;1:15-7.
- 5. Ahmed EA, El-Magd EAA, Hasan GM, et al. A comparative study of propranolol versus silver nitrate cautery in the treatment of recurrent primary epistaxis in children. Adolesc Health Med Ther 2015;30:165-70.
- 6. Diamond L. Managing epistaxix. JAAPA 2014;27:35-9.
- 7. Davies K, Batra K, Mehanna R, Keogh I. Pediatric epistaxis: Epidemiology, management and impact on quality of life. Int J Pediatr Otorhinolaryngol 2014; 78:1294-7.
- 8. Patel N, Maddalozzo J, Billings KR. An update on management of pediatric epistaxis. Int J Pediatr Otorhinolaryngol 2014;78:1400-4.
- 9. Misra A, Basu A, Mandal PK, Mahapatra NC. Management of pediatric epistaxis in different age group in tertiary care centre. Int J Contemp Pediatr 2016;3(4):1206-9.
- 10. Ying-Xia L, Jie-Qiong L, Qing-Long G, Pang C, Huang CL. Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017. Ear Nose Throat J 2020;99(8):513-517.
- 11. Seidel DU, Sesterhenn AM, Kosdev K. Seasonal Variation of Epistaxis in Germany. J Craniofac Surg. 2018;29:365-7.
- 12. Kaygusuz İ, Karlıdağ T, Keleş E, ve ark. Hastaneye yatırılarak tedavi edilen 68 epistaksisli hastanın retrospektif analizi. Fırat Tıp Dergisi 2004;9:82-5.
- 13. Svider P, Arianpour K, Mutchnick S. Management of epistaxis in children and adolescents. Pediatr Clin N Am 2018; 65:607-21.
- 14. Ada M, Işlak C, Canbaz E, Aydın H, Yüksel S, Akar Z. Epistaksis nedeni olarak intrakranial internal karotid arter pseudoanevrizması. Türk Otolaringoloji Arşivi 1994;32:209-11.
- 15. Bilal N, Acıpayam C, Orhan İ, Sağıroğlu S. Çocuklarda epistaksis nedenleri ve prognostik faktörler. Kocaeli Med J 2018;7;2:103-8
- 16. Damrose JF, Maddalazzo J. Pediatric epistaxis. Laryngoscope 2006;116:387– 93.
- 17. Elden V, Reinders M, Witmer C. Predictors of bleeding disorders in children with epistaxis: value of preoperative tests and clinical screening. Int J Pediatr. Otolaryngol 2012;76:767–71.
- 18. Razdan U, Raizada RM, Chaturvedi VN. Efficacy of conservative treatment modalities used in epistaxis. Indian J Otolaryngol Head Neck Surg. 2004;56(1):20-2.
- 19. Walshe P, Harkin C, Murphy S, Shah C, Curran A, McShanee D. The use of fibrin glue in refrectory coagulopathic epistaxis. Clin Otolaryngol 2001;26:284-5.
Abstract
Amaç: Bu çalışmada, epistaksis yakınması ile acil servise başvuran pediatrik olguların demografik, klinik, laboratuvar bulgularını ve uygulanan tedavi yaklaşımlarını geriye dönük olarak değerlendirmek, altta yatan ve eşlik eden durumları saptayarak literatür ile karşılaştırmak amaçlanmıştır.
Gereç ve Yöntemler: 1 Ocak 2018 – 31 Aralık 2018 tarihleri arasında Çocuk Acil Servisine burun kanaması yakınması ile başvuran, 0-18 yaş arasındaki 538 hasta geriye dönük olarak değerlendirildi.
Bulgular: Hastaların 321’i (%59,66) erkek, 217’si (%40,33) kızdı. Yaş ortalaması 9,0 ± 4,7 yıl idi. Hastaların en sık ilkbahar aylarında (%40,66) hastaneye başvurduğu saptandı. Hastaların 532’sinde (%98,88) kronik hastalık, 517’sinde (%96,09) ilaç kullanım öyküsü yoktu. En sık neden idiopatikti. Hastaların 420’sinde ( %78,06) burun kanaması spontan veya hafif baskı ile durmuş ve ek tedavi gereksinimi olmamıştır. 7 (%1,30) hastaya koterizasyon, 3 (%0,55) hastaya tampon uygulanmıştır.
Sonuç: Bu çalışmada epistaksisin en sık nedeninin idiopatik olduğu saptanmıştır. Erişkinlerden farklı olarak altta yatan sistemik hastalık varlığı çocuklarda nadirdir. Vakaların büyük çoğunluğu spontan veya baskı gibi basit tedavi yöntemleri ile tedavi edilirken az sayıda vaka multidisipliner tedavi yaklaşımlarına gereksinim duyabilmektedir.
Keywords
References
- 1. Özcan C. Epistaksis. İçinde: Koç C, editör. Kulak Burun Boğaz Hastalıkları ve Baş Boyun Cerrahisi. Birinci Baskı, Ankara, Güneş Kitabevi, 2004: 479-93.
- 2. Brown NJ, Berkowitz RG. Epistaxis in healthy children requiring hospital admission. Int J Pediatr Otorhinolaryngol 2004;68:1181-4.
- 3. Gifford TO, Orlandi RR. Epistaxis. Otolaryngol Clin North Am 2008;41:525-36.
- 4. Al Khtoum N, Al Roosan M. The evaluation of conservative measures in the treatment of epistaxis. Khartoum Med J 2008;1:15-7.
- 5. Ahmed EA, El-Magd EAA, Hasan GM, et al. A comparative study of propranolol versus silver nitrate cautery in the treatment of recurrent primary epistaxis in children. Adolesc Health Med Ther 2015;30:165-70.
- 6. Diamond L. Managing epistaxix. JAAPA 2014;27:35-9.
- 7. Davies K, Batra K, Mehanna R, Keogh I. Pediatric epistaxis: Epidemiology, management and impact on quality of life. Int J Pediatr Otorhinolaryngol 2014; 78:1294-7.
- 8. Patel N, Maddalozzo J, Billings KR. An update on management of pediatric epistaxis. Int J Pediatr Otorhinolaryngol 2014;78:1400-4.
- 9. Misra A, Basu A, Mandal PK, Mahapatra NC. Management of pediatric epistaxis in different age group in tertiary care centre. Int J Contemp Pediatr 2016;3(4):1206-9.
- 10. Ying-Xia L, Jie-Qiong L, Qing-Long G, Pang C, Huang CL. Pediatric Epistaxis and Its Correlation Between Air Pollutants in Beijing From 2014 to 2017. Ear Nose Throat J 2020;99(8):513-517.
- 11. Seidel DU, Sesterhenn AM, Kosdev K. Seasonal Variation of Epistaxis in Germany. J Craniofac Surg. 2018;29:365-7.
- 12. Kaygusuz İ, Karlıdağ T, Keleş E, ve ark. Hastaneye yatırılarak tedavi edilen 68 epistaksisli hastanın retrospektif analizi. Fırat Tıp Dergisi 2004;9:82-5.
- 13. Svider P, Arianpour K, Mutchnick S. Management of epistaxis in children and adolescents. Pediatr Clin N Am 2018; 65:607-21.
- 14. Ada M, Işlak C, Canbaz E, Aydın H, Yüksel S, Akar Z. Epistaksis nedeni olarak intrakranial internal karotid arter pseudoanevrizması. Türk Otolaringoloji Arşivi 1994;32:209-11.
- 15. Bilal N, Acıpayam C, Orhan İ, Sağıroğlu S. Çocuklarda epistaksis nedenleri ve prognostik faktörler. Kocaeli Med J 2018;7;2:103-8
- 16. Damrose JF, Maddalazzo J. Pediatric epistaxis. Laryngoscope 2006;116:387– 93.
- 17. Elden V, Reinders M, Witmer C. Predictors of bleeding disorders in children with epistaxis: value of preoperative tests and clinical screening. Int J Pediatr. Otolaryngol 2012;76:767–71.
- 18. Razdan U, Raizada RM, Chaturvedi VN. Efficacy of conservative treatment modalities used in epistaxis. Indian J Otolaryngol Head Neck Surg. 2004;56(1):20-2.
- 19. Walshe P, Harkin C, Murphy S, Shah C, Curran A, McShanee D. The use of fibrin glue in refrectory coagulopathic epistaxis. Clin Otolaryngol 2001;26:284-5.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | ORIGINAL ARTICLES |
| Authors | |
| Publication Date | January 22, 2021 |
| Submission Date | October 20, 2020 |
| Published in Issue | Year 2021 Volume: 15 Issue: 1 |
Cited By
Are laboratory evaluations required in every case admitted to the pediatric emergency department with epistaxis?
International Journal of Clinical Practice
https://doi.org/10.1111/ijcp.14749
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