Monday, 3 February 2014

Bleeding sources

Some commonly asked bleeding sources :-

1. Tubercular hemoptysis

A. 80-90 percent cases due to pressure erosion of bronchial artery by active cavitatory lesion / arteritis

B. due to pulmonary arteritis leading to formation of -" RASSMUSSEN'S ANEURYSM " which ruptures leading to hemoptysis (5-10% cases)

2. Mitral stenosis hemoptysis

A. Due to rupture of bronchio- venous plexus due to sudden rise in left atrial pressure

B. due to anti- coagulant therapy ( warfarin) used for prophylaxis of embolic stroke

C. Acute pulmonary oedema - profuse pinkish frothy sputum due to rupture of alveolar capillaries

D. Winter bronchitis ( chronic bronchitis) - blood streaked mucoid sputum

E. pulmonary infarction - frank hemoptysis

F. Pulmonary hemosiderosis - rare

3. Epidural haemorrhage - bleeding from middle meningeal artery

4. Subdural haemorrhage - bleeding from bridging veins connecting calvarial veins to dural veins

5. Sub- arachnoid haemorrhage :-
Due to rupture of berry saccular aneurysm

6. Menstruation - bleeding from spinal arteries of endometrium due to withdrawal of hormones

7. Epistaxis

A. Anterior due to rupture of -" KISSELBACH'S PLEXUS "( formed by anterior and posterior ethmoidal arteries, nasal branch of superior labial artery and branch of spheno- palatine artery )

B. posterior due to bleeding from - " WOODRUFF'S PLEXUS"( formed by union of branch of spheno- palatine artery and posterior pharyngeal artery )

8. Fracture of pelvic bone - " VENOUS BLEEDING"due to rupture of pelvi- venous vascular anastomosis

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