Bleeding in the middle and back of the nose

Introduction There are many causes of nosebleeds, and the bleeding site in the posterior part of the nasal cavity is more common in middle-aged and elderly people over 40 years old, and is mostly related to hypertension. The posterior nasal hemorrhage often flows quickly into the pharynx and spits out from the mouth. In general, nosebleeds caused by local diseases are mostly limited to one side of the nasal cavity, and those caused by systemic diseases may alternate or simultaneously bleed on both sides of the nasal cavity. According to reports: the incidence of high blood pressure in nosebleeds accounted for 10% to 25%. Hypertension is also the most important independent risk factor for stroke.

Cause

In the nasal cavity, the elderly have hardening of the blood vessels. When the blood pressure rises and the blood vessels of the brain are not broken, a certain blood vessel in the nasal cavity may rupture and cause nose bleeding. Therefore, elderly people with hypertension and arteriosclerosis should be especially vigilant in the occurrence of nosebleeds to prevent cerebral hemorrhage.

Hypertensive epistaxis occurs mostly in the morning or after activity, and these patients' blood pressure is susceptible to mental and environmental changes. Because the bleeding site is in the posterior nasal passage, and the blood pressure is very high, the blood vessel elasticity is poor, and the bleeding is often fierce. It is very difficult to stop bleeding by itself.

an examination

Related inspection

Nasal endoscopy

First, physical examination

Taking a medical history gives us a first impression and revelation, and also guides us to a concept of the nature of the disease.

Second, laboratory inspection

Laboratory examinations must be summarized and analyzed based on objective data learned from medical history and physical examination, from which several diagnostic possibilities may be proposed, and further consideration should be given to those examinations to confirm the diagnosis. Such as:

1, front nose examination.

2, X-ray nasal photos clearly with or without sinus infection.

3, blood pressure, brain CT examination.

Differential diagnosis

Differential diagnosis of posterior hemorrhage in the nasal cavity:

Anterior nasal bleeding: Nose bleeding is a common symptom of otolaryngology, more than 80% of which is anterior nasal bleeding, and nasal bleeding is easier to handle. Children's nosebleeds occur almost entirely in the front of the nose; young people have more common bleeding in the front of the nose, and a few severe bleeding occurs in the back of the nose.

Hypertension: Most of the nosebleeds occur in the morning or after the activity. The blood pressure of these patients is susceptible to mental and environmental changes. Because the bleeding site is in the posterior nasal passage, and the blood pressure is very high, the blood vessel elasticity is poor, and the bleeding is often fierce. It is very difficult to stop bleeding by itself.

The posterior nasal hemorrhage often flows quickly into the pharynx and spits out from the mouth. In general, nosebleeds caused by local diseases are mostly limited to one side of the nasal cavity, and those caused by systemic diseases may alternate or simultaneously bleed on both sides of the nasal cavity.

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