Etiology and Management of Epistaxis in Makurdi, North-Central Nigeria: An Eight Year Descriptive Review

Background: Epistaxis or bleeding from the nose is a fairly common emergency presentation in otorhinolaryngological practice. The aim of this study is to describe the etiological profile and management outcome of epistaxis in Makurdi and compare our findings with those of other centers.

Methods: This is an eight year retrospective review of medical records of two tertiary health facilities of all patients with complaints of epistaxis managed at the Ear, Nose and Throat clinics; accident and emergency units; ward admissions and theatres of the Benue State University Teaching Hospital, and Federal Medical Centre, Makurdi between June 2009 and May 2017. Data retrieved included demographics, cause of epistaxis (comorbidities, medications), and site of bleeding, treatment protocol and complications.

Results: A total of 107 patients presented with epistaxis out of 11839 that were attended to at the hospitals during the period under review. There were 4281 cases with nasal pathologies within the same period. Of the 107 patients, there were 70 males and 37 females (M:F=1.9:1). Their ages ranged from 6 to 73 years with a mean of 22.5+-3.7 years. 43.5% of patients were in their 4th and 5th decades. Etiological factors included idiopathic (27.2%), hypertension/atherosclerosis (25.0%), and trauma (21.7%). Most of the cases were anterior in origin which constituted 64%. Ninety-two (86%) of the patients were successfully managed while recurrence occurred in 15(14%). Nasal packing was the commonest procedure done which accounted for 65.2%. Complications encountered included multiple blood transfusions (6.6%), intranasal adhesions (2.2%) and death (2.2%), with complication rate of 11%.

Conclusion: In Makurdi, epistaxis is a significant nasal presentation in the 4th and 5th decades of life. Idiopathic etiology, cardiovascular factors and trauma are the commonest causes. Anterior epistaxis is also common. Conservative method of treatment was effective in the control of epistaxis prior to treating the cause if known.