title: Recurrent epistaxis from Kiesselbach area syndrome in patients suffering from hemorrhoids: fact or fiction?
abstract: BACKGROUND
  It has been found that >90% of patients suffering from recurrent epistaxis from Kiesselbach area syndrome (REKAS) simultaneously suffered from hemorrhoids. To clarify this, the authors decided to investigate in the opposite direction, i.e., to find out whether or not REKAS occurs in patients suffering primarily from hemorrhoids.
  
  
  METHODS
  The study group included 53 randomly selected hospitalized patients with hemorrhoidal disorder (31 males and 22 females: age range 18-57 years). A search for essential clinical signs of REKAS was performed in each patient.
  
  
  RESULTS
  Incidence was not high, although all clinical parameters were nearly the same: dilated vessels in Kiesselbach venous plexus (83.01%) and a positive hereditary factor (92.7%). The only missing factor in patients with hemorrhoids was anterior septal deformity, so frequent in REKAS patients. CONCLUSIONS; The authors conclude that REKAS and hemorrhoidal syndrome are separate clinical entities that are characterized by dilated vessels of similar venous plexus and simultaneous appearance in the same patient or close relatives.
authors.affiliation: Otorhinolaryngology (ORL) Department, Salata University Hospital, Salata #3, Zagreb, 10,000 Croatia. prof_mladina@doctor.com
authors.forename: Ranko
authors.initials: R
authors.lastname: Mladina
authors.forename: Josip
authors.initials: J
authors.lastname: Cavcic
authors.forename: Marin
authors.initials: M
authors.lastname: Subaric
mesh_terms: D000293:Adolescent; D000328:Adult; D004108:Dilatation, Pathologic; D004844:Epistaxis / Q000150:complications* / Q000235:genetics; D005260:Female; D006484:Hemorrhoids / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000002:abnormalities / Q000033:anatomy & histology / Q000098:blood supply; D012008:Recurrence; D013577:Syndrome