Endoscopic Sphenopalatine Artery Ligation

A 58-year-old female on Plavix presented to the ER with recurrent left-sided epistaxis after two prior endoscopic control of epistaxis at an outside hospital.  The patient’s hemoglobin and hematocrit at presentation were 8.3 gm/dL and 25.4%.  Given the unilateral presentation, antiplatelet therapy, and recently failed endoscopic control, the patient was taken to the operating room for transnasal endoscopic sphenopalatine artery ligation (TESPAL) with bipolar cautery.

Contributors:

Mathew Geltzeiler and Eric Wang

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