title: Prospective clinical study of bleeding sites in idiopathic adult posterior epistaxis.
abstract: OBJECTIVE
  The precise identification of the bleeding point is important to the efficient management of epistaxis. Our hypothesis was that the septum was the commonest bleeding site.
  
  
  METHODS
  This was a prospective clinical study of 50 consecutive adult idiopathic posterior epistaxis patients carried out in a busy teaching hospital.
  
  
  METHODS
  The nasal cavity was inspected with endoscopy to identify the site of bleeding before any intervention. The location of bleeding sites was recorded on a proforma.
  
  
  RESULTS
  Of bleeding sites posterior to the piriform fossa, 94 percent were identifiable, with 70 percent arising from the septum.
  
  
  CONCLUSIONS
  This is the largest prospective study of the bleeding site in adult patients with posterior epistaxis and the only one with a well-defined population. The vast majority of posterior bleeding sites can be identified by endoscopy without general anesthesia. The septum should be examined closely in cases of idiopathic bleeding.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong. torchiu@surgery.cuhk.edu.hk
authors.forename: Tor W
authors.initials: TW
authors.lastname: Chiu
authors.forename: Gerry W
authors.initials: GW
authors.lastname: McGarry
mesh_terms: D000328:Adult; D004636:Emergency Service, Hospital; D004724:Endoscopy; D004844:Epistaxis / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum; D011446:Prospective Studies; D014420:Turbinates