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Lethal Epistaxis
1Forensic Science SA, 21 Divett Place, Adelaide, 5000, Australia. roger.byard@sa.gov.au.
Journal of Forensic Sciences
|June 11, 2016
Summary
Epistaxis, or nosebleeds, can be fatal, sometimes with no identifiable source. This study examines three lethal cases, highlighting diverse causes and the challenges in pinpointing bleeding origins.
Area of Science:
- Forensic Pathology
- Otolaryngology
Background:
- Epistaxis (nosebleed) is bleeding from the nasal cavity or nasopharynx.
- While often minor, epistaxis can occasionally cause severe, life-threatening hemorrhage.
Observation:
- Three cases of fatal epistaxis are presented.
- Case 1: A woman with lethal epistaxis and no identified bleeding source.
- Case 2: A man with fatal epistaxis from a neovascularized nasopharyngeal carcinoma.
- Case 3: A boy with fatal epistaxis due to hemophilia B, complicated by airway obstruction.
Findings:
- Fatal epistaxis can arise from diverse conditions, including tumors and bleeding disorders.
- Identifying the precise bleeding source in lethal epistaxis can be challenging, even with postmortem imaging.
- Predisposing factors include trauma, tumors, vascular malformations, bleeding diatheses, infections, pregnancy, endometriosis, and certain medications.
Implications:
- Understanding the varied causes of severe epistaxis is crucial for diagnosis and management.
- Advanced imaging like postmortem computerized tomographic angiography (PCTA) may aid in identifying bleeding sites.
- Further research is needed to improve the identification and treatment of difficult-to-locate epistaxis sources.
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