A patient is a 25-year-old male who presents with a several hours'–long nosebleed. He stated he was in usual state of good health when his nose started bleeding after he blew it particularly hard. He denies any injury to his nose. He has no history of liver disease or hypertension. Patient is on no medication, either prescription or over-the-counter.
The bleeding did not stop even after applying pressure to the right nares, pressing it against the septum for 10 minutes. A nasal speculum was used to examine the internal nares, and the source of the bleeding—a small vein—was noted. The vein was chemically cauterized with a stick of silver nitrate. The patient tolerated the procedure well. He was observed for another hour and when the bleeding did not start again, he was instructed to not blow his nose for at least 48 hours and to contact his PCP for follow-up.
Dx: Epistaxis
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