Epistaxis following post nasal swabbing – the new COVID related emergency?

Abstract

Case overview A patient who got admitted at term for an elective caesarean section underwent an ‘on admission’ routine nasopharyngeal swabbing for SARS-CoV-2. She developed resistant epistaxis one day after the procedure and was found to have a mucosal injury over the sphenopalatine artery entry point on the left side. She had to undergo an emergency caesarean section followed by endonasal sphenopalatine artery ligation. The epistaxis was successfully dealt with and the mother and baby were discharged 48 hours after surgery. Conclusions Proper training in nasopharyngeal swab technique is required. Departments need to consider having biodegradable nasal packing material for such instances. In such injuries early endonasal sphenopalatine artery ligation (ESPAL) should be considered as traditional methods available to us were not successful.