Massive epistaxis from aneurysm of the carotid artery

The syndrome of massive and sometimes fatal epistaxis from an aneurysm of the internal carotid artery is reviewed. Two cases are reported in which exsanguination occurred with anterior and posterior gauze packing in place. The use of standard methods for controlling severe epistaxis in this syndrome was a futile exercise. This distressing and frustrating experience prompted the development of an emergency method to prevent exsanguination pending definitive surgical treatment. A description of this technique is presented and a proposal made for its use.