[A Case of Absolute Ethanol Sclerotherapy and an Adhesion Maneuver for Refractory Epistaxis Associated with Osler’s Disease].

Case Report : We report herein on the case of a 75 years old woman with refractory epistaxis associated with Osler’s disease. Anemia and recurrent epistaxis occurred 10 years previously, and anemia was treated by a physician near the patient’s home. Because she had gradually become unable to control her epistaxis, she visited our hospital. We diagnosed Osler’s disease based on her family history, past history, and dilatory changes in the peripheral and nasal mucosa vessels. A skin graft failed and ultrasonic coagulation was not so effective. The refractory epistaxis was due to a connected arteriovenous fistula of the right upper nasal valve. Following ethanol injection sclerotherapy and an adhesion maneuver, the epistaxis was well controlled.