Pediatric Epistaxis (Nosebleeds)

Nose bleeds can be life threatening and very scary. There are two categories of nose bleeds, anterior and posterior.

Anterior nose bleeds are the most common and are due to the superficial vessels of the septum and turbinates cracking and subsequently bleeding. The vessels may need to be cauterized and/or packed.

Posterior nose bleeds can be caused by the same superficial vessels but are further back, thus more difficult to identify and cauterize. Bigger arteries which enter the nose from the sinus, Internal Maxillary Artery (IMA), can also be the cause and are usually associated with patients with high blood pressure. If packing and/or cauterization does not stop the bleeding, then surgery or a radiologic procedure to clog the vessel may be required.

Possible Testing

• Nasal endoscopy
• Computed tomography (CT) scan of the sinuses
• MRI base of skull

Possible Treatments

• Endoscopic cauterization
• Nasal Pack (Rapid Rhino)
• Ligation of Internal Maxillary Artery (IMA)
• Embolization of Internal Maxillary Artery (IMA)
• Septoplasty

Fact Sheets

• Nose Bleeds