%0 Journal Article
%T Bilateral hemotympanum as a result of spontaneous epistaxis
%A Vural Fidan
%A Kemal Ozcan
%A Filiz Karaca
%J International Journal of Emergency Medicine
%D 2011
%I BioMed Central
%R 10.1186/1865-1380-4-3
%X Hemotympanum is most often associated with basilar skull fractures or nasal packing. Only six cases associated with spontaneous epistaxis have been described in the literature [1,2]. Because of this rare situation, we present the case of a 51-year-old woman with bilateral hemotympanum secondary to spontaneous epistaxis. Initial evaluation must include an audiogram and radiological imaging (computed tomography, magnetic resonance imaging, etc.). Close follow-up of the patient is necessary for reducing the risk of long-term sequelae such as cholesterol granuloma [3].A 51-year-old woman was referred to the emergency department with a complaint of epistaxis associated with exercise. She had been sweeping her house when she noticed the epistaxis. Her history indicated that after epistaxis had started, she went to the sink and cleaned her nose with water. She had pressed on her nose and called an ambulance. About 30 min after the start of epistaxis, an ambulance and emergency doctor arrived. The bleeding stopped while she was in the ambulance. Her blood pressure was 125/80 mmHg. She had an unremarkable past medical history and did not have coagulation diathesis or trauma/barotrauma, nor was she undergoing anticoagulant or salicylate therapy. She complained of slight hearing loss and a feeling of fullness in both ears. The physical examination was normal except for red-blue tympanic membranes and bilateral septal excoriation. There were no other petechiae or ecchymoses on the skin or mucous membranes. Her hematologic, biochemical and coagulation tests were also normal. Temporal bone fracture was ruled out by computed tomography scan.She was referred to the emergency department 2 days after the problem had started. In our examination, we found bilateral blue ear drums (Figures 1 and 2), inactive epistaxis and septal excoriation (Figure 3). An audiogram demonstrated moderate bilateral conductive hearing loss, and the tympanogram findings were type b (flat type). After consul
%U http://www.intjem.com/content/4/1/3