Question:medium
A 78-year-old male, known case of diabetes mellitus and hypertension presents with nasal bleeding. Initial management such as packing was not successful in controlling the bleed. Which artery should be ligated to control the bleeding?
A 78-year-old male, known case of diabetes mellitus and hypertension presents with nasal bleeding. Initial management such as packing was not successful in controlling the bleed. Which artery should be ligated to control the bleeding?
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Uncontrolled posterior epistaxis commonly requires sphenopalatine artery ligation.
Updated On: May 14, 2026
- Sphenopalatine artery
- Anterior ethmoidal artery
- Posterior ethmoidal artery
- Greater palatine artery
Show Solution
The Correct Option is A
Solution and Explanation
Step 1: Understanding the Question:
The patient is an elderly male with comorbidities presenting with severe epistaxis (nasal bleeding) that is refractory to packing.
In elderly patients, bleeding is more likely to be posterior, where the Sphenopalatine artery is the major blood supply.
Step 2: Detailed Explanation:
Arterial Supply of the Nose:
Sphenopalatine Artery: Known as the "Artery of Epistaxis". It is a branch of the maxillary artery and supplies most of the posterior part of the nasal septum and lateral wall.
Management of Refractory Epistaxis:
If anterior and posterior packing fails, surgical intervention is required.
Endoscopic Sphenopalatine Artery Ligation (ESPAL): Is currently the preferred surgical method for controlling severe posterior epistaxis. It is highly effective because it ligates the vessel close to the site of bleeding.
Analyzing other options:
Ethmoidal arteries (B & C): Supply the superior part of the nose and are branches of the ophthalmic artery.
Greater Palatine artery (D): Supplies the inferior part of the septum via the incisive canal.
Step 3: Final Answer:
The sphenopalatine artery is the primary vessel targeted for ligation in cases of intractable posterior epistaxis.
The patient is an elderly male with comorbidities presenting with severe epistaxis (nasal bleeding) that is refractory to packing.
In elderly patients, bleeding is more likely to be posterior, where the Sphenopalatine artery is the major blood supply.
Step 2: Detailed Explanation:
Arterial Supply of the Nose:
Sphenopalatine Artery: Known as the "Artery of Epistaxis". It is a branch of the maxillary artery and supplies most of the posterior part of the nasal septum and lateral wall.
Management of Refractory Epistaxis:
If anterior and posterior packing fails, surgical intervention is required.
Endoscopic Sphenopalatine Artery Ligation (ESPAL): Is currently the preferred surgical method for controlling severe posterior epistaxis. It is highly effective because it ligates the vessel close to the site of bleeding.
Analyzing other options:
Ethmoidal arteries (B & C): Supply the superior part of the nose and are branches of the ophthalmic artery.
Greater Palatine artery (D): Supplies the inferior part of the septum via the incisive canal.
Step 3: Final Answer:
The sphenopalatine artery is the primary vessel targeted for ligation in cases of intractable posterior epistaxis.
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