Q: 34 year old male recent immigrant from China is admitted via ED to ICU where he presented with massive epistaxis without any provocation. Emergent Ear-Nose-Throat service was obtained in ER to control the hemorrhage. What is the underlying concern?
Answer; Nasopharyngeal cancers
Epistaxis can be either from anterior or posterior vessels. Anterior nosebleeds are the most common and usually benign. Posterior nose-bleeds can be potentially life-threatening, and be a sign of major clinical disease like carotid artery aneurysm or neoplasm.
Nasopharyngeal cancers are common in patients of Chinese origin and can result in massive bleeding.
#ENT
#surgical-critical-care
References:
1. Liu JK, Gottfried ON, Amini A, Couldwell WT. Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment. Neurosurg Focus 2004; 17:E13.
2. Chen D, Concus AP, Halbach VV, Cheung SW. Epistaxis originating from traumatic pseudoaneurysm of the internal carotid artery: diagnosis and endovascular therapy. Laryngoscope 1998; 108:326.
3. CHENG HER. Nasopharyngeal Cancer and the Southeast Asian Patient Am Fam Physician. 2001 May 1;63(9):1776-1783.
Answer; Nasopharyngeal cancers
Epistaxis can be either from anterior or posterior vessels. Anterior nosebleeds are the most common and usually benign. Posterior nose-bleeds can be potentially life-threatening, and be a sign of major clinical disease like carotid artery aneurysm or neoplasm.
Nasopharyngeal cancers are common in patients of Chinese origin and can result in massive bleeding.
#ENT
#surgical-critical-care
References:
1. Liu JK, Gottfried ON, Amini A, Couldwell WT. Aneurysms of the petrous internal carotid artery: anatomy, origins, and treatment. Neurosurg Focus 2004; 17:E13.
2. Chen D, Concus AP, Halbach VV, Cheung SW. Epistaxis originating from traumatic pseudoaneurysm of the internal carotid artery: diagnosis and endovascular therapy. Laryngoscope 1998; 108:326.
3. CHENG HER. Nasopharyngeal Cancer and the Southeast Asian Patient Am Fam Physician. 2001 May 1;63(9):1776-1783.
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