Management Pattern of Epistaxis in Sokoto, Nigeria

Abstract

Background: Epistaxis is a life threatening otorhinolaryngological emergency presenting as acute or chronic recurrent bleeds. Objectives: The study was designed to evaluate the treatment modality used in managing patients with epistaxis in Sokoto. Methods: It was a prospective hospital-based study involving 135 patients presenting with epistaxis to Usmanu Danfodiyo University Teaching Hospital (UDUTH). Information on treatment received, blood transfusion, hospital admission and length of hospital-stay were obtained. Results: A total of 133 (98.5 %) patients were managed non-surgically, while 2 (1.5 %) patients received surgical intervention. Of those who received non-surgical treatment; 60 (44.4%) had anterior nasal packing, while 27 (20.0%) had endoscopic cauterization. Out of this, 25 (18.5%) had endoscopic chemical cauterization for bleeding in the Little`s area, retrocolumellar and septum, whereas 2 (1.5%) had bipolar cauterization for bleeding on the Woodruff`s plexus. Twenty (14.8%) patients had both anterior and posterior nasal packing, 15 (11.1%) had combined nasal pinching and ice pack, while 11 (8.2%) had posterior nasal packing only. Two (1.5%) patients had ligation of the internal maxillary artery (surgical intervention).Of all the patients presented, 22 (16.3%) required blood transfusion during their management and 43 (31.9 %) needed admission. The duration of hospital-stay ranged from 1 to 9 days with a mean of 5.7 ± 1.9 days. Conclusion: Non-surgical intervention is the most common modality used in managing epistaxis in the study centre, with anterior nasal packing as the major method employed. In addition, some patients required blood transfusion and hospital admission.