Sujana, Widia Isa Aprillia and Wijaya, Julian Hartawan (2026) Review Article: Understanding Epistaxis, Clinical Evaluation, And Stepwise Management. Journal of Widya Medika Junior, 8 (1). pp. 56-65. ISSN 26561409
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Abstract
Epistaxis, derived from the Greek term epistazein, refers to bleeding originating from the nasal cavity or nasopharynx and represents one of the most common emergencies encountered in otolaryngology. Approximately 60% of the global population experiencesepistaxis at least once during their lifetime; however, onlya small proportion require medical intervention. The clinical severity ranges from self-limiting anterior bleeding to life threatening hemorrhage, particularly in patients with cardiovascular disease, coagulation disorders, or platelet dysfunction. Etiologically, epistaxis is classified into local, systemic, or idiopathic causes and demonstrates a bimodal age distribution, predominantly affecting children and adults older than 50 years. Anterior epistaxis, most commonly arising from Kiesselbach plexus, accounts for the majority of cases and is typically mild and self-limited. In contrast, posterior epistaxis occurs less frequentlybut is often associated with greater morbidity and higher hospitalization rates.Initial evaluation prioritizes airway protection and hemodynamic stabilization, followed by focused history taking, physical examination, and selective laboratory investigations when indicated. Management strategies range from conservative measures, including digital nasal compression, topical vasoconstrictors, tranexamic acid administration, chemical cauterization, and nasal packingto more invasive interventions such as endoscopic cauterization, arterial ligation, or endovascular embolization in refractory or severe cases. Advances in endoscopic techniques and the development of absorbable nasal packing materials have improved treatment efficacy, enhancedpatient comfort, and reduced complication rates.Conclusion: Epistaxis is a common otolaryngologic emergency with a broad spectrum of clinical severity. Although most cases can be managed conservatively, a comprehensive understanding of its etiology, vascular anatomy, and stepwise management is essential to optimize outcomes and minimize morbidity and mortality.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Clinical evaluation; Epistaxis; Stepwise management |
| Subjects: | Medicine |
| Divisions: | Journal Publication |
| Depositing User: | F.X. Hadi |
| Date Deposited: | 07 Apr 2026 07:39 |
| Last Modified: | 07 Apr 2026 07:39 |
| URI: | https://repositori.ukwms.ac.id/id/eprint/46544 |
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