The use of fibrin glue in refractory coagulopathic epistaxis

Epistaxis can be particularly difficult to treat when a patient has a coagu lopathy, even if the area bleeding is visible. Where routine measures fail to arrest the bleeding (e.g., nasal cautery and packing), the application o f fibrin glue is successful in stopping the bleeding without having to addr ess the underlying coagulopathy. Ten patients with epistaxis secondary to a n underlying coagulopathy were treated by local application of fibrin glue to the area bleeding. The bleeding stopped immediately in all patients when the fibrin glue was applied. No patients suffered complications. Fibrin gl ue application should be considered as a cost-effective means of controllin g epistaxis from an identifiable area in the nasal cavity in patients with a coagulopathy.