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The problem with nose bleeds

A Dai1, E Jurges

  • 1Kingston Hospital, Galsworthy Road, Kingston-upon-Thames, Surrey KT2 7QB, UK. anniedai@fsmail.net

Emergency Medicine Journal : EMJ
|July 28, 2005
PubMed

Insights

Paediatric epistaxis, or nosebleeds, can be severe. A rare case involved hypovolaemic shock from a dissecting internal carotid artery aneurysm after an oropharyngeal injury.

Area of Science:

  • Otolaryngology
  • Vascular Surgery
  • Emergency Medicine

Background:

  • Epistaxis is a frequent pediatric emergency, typically minor and self-resolving.
  • Severe epistaxis necessitates prompt diagnosis and management to prevent complications.

Observation:

  • A child presented with atypical epistaxis and signs of hypovolaemic shock.
  • The cause was identified as a dissecting false aneurysm of the internal carotid artery.

Findings:

  • The internal carotid artery dissection resulted from an impalement injury to the oropharynx.
  • This rare etiology led to life-threatening haemorrhage and hypovolaemic shock.

Implications:

  • Highlights the importance of considering rare vascular causes in pediatric epistaxis with hemodynamic instability.
  • Emphasizes the need for advanced imaging and surgical intervention in such critical cases.
  • Underscores the potential for delayed recognition of serious internal carotid artery injuries from oropharyngeal trauma.

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