{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T07:20:57Z","timestamp":1773040857442,"version":"3.50.1"},"reference-count":6,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,28]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Nosebleeds are among the most familiar presentations to the emergency department as well as otorhinolaryngologic outpatient services. Bleeding from nasal septal branches of the anterior ethmoid artery (AEA) is common and can be effectively controlled endoscopically. However, the bleeding from a pseudoaneurysm involving the nasal septal branches of AEA is extremely rare and can be troublesome to control using endoscopic methods. We report an adult patient presenting with profuse nasal bleeding postroad traffic accident due to the formation of AEA septal branch pseudoaneurysm. The patient required repeated nasal packing, and the diagnosis was revealed using digital subtraction angiography. Since profuse active bleeding precluded endoscopic visualisation, an external approach had to be adopted to ligate the AEA to control the bleeding. We discuss the management options and nuances for this rare cause of the troublesome nasal bleeding.<\/jats:p>","DOI":"10.1136\/bcr-2021-244231","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T13:02:12Z","timestamp":1629118932000},"page":"e244231","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Unusual cause of recalcitrant epistaxis"],"prefix":"10.1136","volume":"14","author":[{"given":"Gaurav","family":"Khatri","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head & Neck Surgery, Medanta \u2013 The Medicity, Gurugram, Haryana, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9893-7106","authenticated-orcid":false,"given":"Anup","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head & Neck Surgery, Medanta \u2013 The Medicity, Gurugram, Haryana, India"},{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anshu","family":"Mahajan","sequence":"additional","affiliation":[{"name":"Department of Neurointervention Surgery, Medanta \u2013 The Medicity, Gurugram, Haryana, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kumud Kumar","family":"Handa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head & Neck Surgery, Medanta \u2013 The Medicity, Gurugram, Haryana, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,8,16]]},"reference":[{"key":"2025082701431213000_14.8.e244231.1","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1007\/s00405-018-4964-x","article-title":"Septal branches of the anterior ethmoidal artery: anatomical considerations and clinical implications in the management of refractory epistaxis","volume":"275","author":"Turri-Zanoni","year":"2018","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2025082701431213000_14.8.e244231.2","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1007\/PL00021048","article-title":"Endovascular treatment of persistent epistaxis due to pseudoaneurysm formation of the ophthalmic artery secondary to nasogastric tube","volume":"28","author":"Selcuk","year":"2005","journal-title":"Cardiovasc Intervent Radiol"},{"key":"2025082701431213000_14.8.e244231.3","doi-asserted-by":"crossref","DOI":"10.4103\/2152-7806.130561","article-title":"Use of Dyna CT in evaluation and treatment of pseudoaneurysm secondary to craniofacial tumor resection: case report and diagnostic implications","volume":"5","author":"Patel","year":"2014","journal-title":"Surg Neurol Int"},{"key":"2025082701431213000_14.8.e244231.4","doi-asserted-by":"crossref","first-page":"72","DOI":"10.5797\/jnet.cr.2018-0075","article-title":"Traumatic anterior ethmoidal artery pseudoaneurysm with repeated epistaxis treated by transarterial embolization: a case report","volume":"13","author":"Kuranari","year":"2019","journal-title":"J Neuroendovascular Ther"},{"key":"2025082701431213000_14.8.e244231.5","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1002\/alr.22684","article-title":"Management of epistaxis secondary to extracranial anterior ethmoid artery pseudoaneurysm","volume":"10","author":"Hill","year":"2020","journal-title":"Int Forum Allergy Rhinol"},{"key":"2025082701431213000_14.8.e244231.6","doi-asserted-by":"crossref","first-page":"104","DOI":"10.5005\/jp-journals-10001-1344","article-title":"Postoperative epistaxis due to pseudoaneurysm: a rare case","volume":"9","author":"Duggal","year":"2018","journal-title":"Int J Head Neck Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-244231","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:43:18Z","timestamp":1756284198000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-244231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":6,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,16]]},"published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1136\/bcr-2021-244231"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-244231","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}