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Oxford Challenging Concepts in Interventional Radiology Cases with Expert Commentary: Part 2

(BQ) Continued part 1, part 2 of the document Secrets in critical care (Sixth edition) has contents: Renal replacement therapy and rhabdomyolysis, acute pancreatitis, diabetic ketoacidosis and hyperosmolar hyperglycemic state, disseminated intravascular coagulation, alcohol withdrawal, and other contents. Invite you to refer. | Oxford Challenging Concepts in Interventional Radiology Cases with Expert Commentary Part 2 Case 16 Epistaxis which embolic materials to use SECTION 3 Embolization Case 16 Epistaxis which embolic materials to use Case 17 Massive haemoptysis what to embolize Case 18 Gastrointestinal bleeding which embolic material to use Case 19 Endovascular approach to the trauma patient Case 20 Uterine fibroid embolization can fertility be preserved Case 21 Postpartum haemorrhage what is the role of occlusion balloons Case 22 Percutaneous varicelectomy coils or sclerosant agents Case 23 Prostate artery embolization for benign prostate hypertrophy CA SE Epistaxis which embolic materials 16 to use Magdalena Jarząbek and Piotr Trojanowski Expert commentary Małgorzata Szczerbo-Trojanowska Case history A 20-year-old male arrived via ambulance at the A amp E Department with severe epistaxis due to maxillofacial trauma following a fall from a height. The patient was conscious. His blood pressure at the time of admission to the hospital was 145 85mmHg his pulse was 85 beats min and an ECG demonstrated normal sinus rhythm. Blood count showed a haemoglobin level of 10.3g dl. Blood coagulation parameters were within normal limits. Anterior nasal packing was performed as first-line treatment. Computer tomog- raphy of the head revealed a nasal septum fracture as well as blood in the left nasal cavity and within the left maxillary sinus Figure 16.1 . Clinical tip In patients with massive epistaxis it is essential to localize the origin of the bleeding. Depending to the location of the source of bleeding epistaxis is classified as anterior or posterior which require different methods of treatment. Anterior epistaxis from Kiesselbach s plexus anterior septum is more frequent but often less severe. First-line therapies such as vasoconstriction cautery or anterior nasal packing are usually sufficient. Posterior bleeding which occurs in the posterior superior part of the nasal cavity is usually .