Abstract
A 50-year-old man, with no previous history of epistaxis, was hospitalized at our facility for left recurrent posterior epistaxis. The patient underwent surgical treatment three times and only the operator's experience and radiological support (cranial angiography) allowed us to control the epistaxis and stop the bleeding. The difficult bleeding management and control was attributed to an abnormal course of the left posterior ethmoidal artery. When bleeding seems to come from the roof of the nasal cavity, it is important to identify the ethmoid arteries always bearing in mind the possible existence of anomalous courses.
Highlights
Epistaxis is the most common emergency encountered by the otolaryngologist-head and neck surgeon and affects all age groups, with different incidence rates
We report an unusual case of epistaxis arising from the left posterior ethmoid artery, which presented an abnormal course
We report the case of a 50-year-old man affected by hypertension and chronic ischemic heart disease with no previous history of epistaxis and who we hospitalized at our facility for left recurrent posterior epistaxis
Summary
Epistaxis is the most common emergency encountered by the otolaryngologist-head and neck surgeon and affects all age groups, with different incidence rates. It is most common before age 10 and between ages 45 and 65 years [1, 2]. Nasal packing usually provides good control of epistaxis but sometimes, especially in arterial bleeding, surgical treatment represents the only available treatment and can be troublesome, even for experienced surgeons [3]. We report an unusual case of epistaxis arising from the left posterior ethmoid artery, which presented an abnormal course. Control of epistaxis was difficult and was only achieved after three surgical interventions
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