Factitious Disorder - A Rare Cause for Unexplained Epistaxis.

Area of Science:

• Otorhinolaryngology
• Psychiatry
• Behavioral Science

Background:

• Epistaxis (nasal bleeding) is a common condition requiring medical or surgical intervention.
• Factitious disorder presenting as epistaxis is a rare clinical entity.
• Undergraduate surgical training may lack sufficient exposure to complex behavioral issues, potentially leading to missed diagnoses.

Observation:

• A patient presented with recurrent epistaxis to surgical causality.
• The underlying cause was suspected to be factitious disorder, a condition where individuals feign illness.
• Collaboration between surgical and otorhinolaryngology departments was established.

Findings:

• The patient's epistaxis was determined to be factitious in nature.
• Multidisciplinary evaluation was crucial for accurate diagnosis.
• Management involved a combination of antidepressant medication and cognitive behavioral therapy.

Implications:

• This case underscores the need for surgeons to consider psychological phenomena in unexplained epistaxis.
• Early recognition and appropriate psychiatric referral are vital for effective management.
• Integrated treatment approaches combining medical and psychological interventions can successfully manage factitious epistaxis.