Case report

Sphenopalatine-sphenopalatine anastomosis: a unique cause of intractable epistaxis, safely treated with microcatheter embolization: a case report

Tawakir Kamani¹ , Simon Shaw² , Ahmed Ali¹ , George Manjaly³ and Martin Jeffree⁴

¹  Royal Albert and Edward Infirmary, Wigan, UK

²  Royal Bolton Hospital, Bolton, UK

³  Eastbourne District General Hospital, Eastbourne, East Sussex, UK

⁴  Hurstwood Park Neurological Centre, Haywards Heath, UK

author email corresponding author email

Journal of Medical Case Reports 2007, 1:125doi:10.1186/1752-1947-1-125

Published:	31 October 2007

Abstract

Epistaxis is the most common emergency presenting to the ENT surgeon. Here we present a case of epistaxis arising from the sphenopalatine artery in a patient who had previously had the ipsilateral external carotid artery ligated due to previous epistaxis. On investigation the epistaxis was determined to arise from an anastamosis with the contralateral sphenopalatine artery. The anatomy was demonstrated with angiography and the epistaxis treated using microcatheter embolization. Anatomical variation can be a cause for failure of ligation as a permanent treatment for epistaxis. Embolization is used less frequently for epistaxis control due to concerns about the risks involved, but it can be a valuable treatment option in intractable epistaxis following a failure of arterial ligation.