Delayed post-traumatic intractable epistaxis due to pseudoaneurysms in concha bullosa: a case report

Abstract Background Delayed post-traumatic bleeding at various sites is known due to vascular abnormalities related structural changes in the vessel walls, form of pseudo aneurysms and arteriovenous malformations. epistaxis following facial trauma a distinct entity that presents as recurrent episodes from nose. History important differentiate it idiopathic intractable epistaxis, management which less dramatic beginning endoscopy electrocauterization. However, uncontrolled delayed usually requires embolization. We report rare case associated with multiple pseudoaneurysms (PA), inside concha bullosa, where even embolization was unsuccessful. Case presentation A 25-year-old male patient presented casualty referred Otorhinolaryngology department for profuse left nasal cavity, conservative measures like packing, electrocauterization did not help. Patient had history fall height bone fractures 1 month back. Angiography revealed blush dilatation (pseudoaneurysms) branches internal maxillary arteries, ascending pharyngeal labial arteries done Interventional Radiology Department. Post-embolization, again developed massive epistaxis. The explored under general anaesthesia, find out site bleed by endoscopy. Collected blood found bullosa. Conchoplasty middle turbinate cauterization vessels. no further discharged stable condition. He asymptomatic last 6 months. Conclusion Post-traumatic cause trauma. helps localization source cavity can identify pseudoaneurysmal dilatations Our highlights importance hidden points bullosa unresponsive