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Life-threatening traumatic epistaxis due to massive bleeding into the maxillary sinus
Rika Kotoh1, Takaaki Maruhashi1, Satoshi Tamura1
1Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Trauma Case Reports
|March 5, 2021
Summary
A severe facial injury led to internal bleeding and hemorrhagic shock. Transcatheter arterial embolization successfully treated the ruptured infraorbital artery, saving the patient.
Area of Science:
- Trauma Surgery
- Interventional Radiology
- Vascular Medicine
Background:
- Facial trauma can cause severe epistaxis (nosebleeds) and internal hemorrhage.
- Hemorrhagic shock is a life-threatening condition requiring prompt intervention.
Observation:
- A 77-year-old woman sustained facial trauma resulting in delayed, concealed hemorrhage into the maxillary sinus.
- Initial endoscopic attempts to control bleeding failed, leading to hemorrhagic shock.
Findings:
- Contrast-enhanced computed tomography identified extravasation into the maxillary sinus.
- Transcatheter arterial embolization effectively occluded the ruptured infraorbital artery, stemming the hemorrhage.
Implications:
- Transcatheter arterial embolization is a safe and effective treatment for life-threatening epistaxis secondary to facial trauma.
- Early recognition of concealed hemorrhage in facial trauma is crucial for timely intervention.
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