Sent Packing

Question: A 62 year old male is evaluated for recurrent epistaxis after being placed on warfarin for new onset atrial fibrillation.  The episodes are exclusively left sided and tend to be high volume.  During a particularly severe bleed, nonabsorbable packs with internal balloon catheters are placed bilaterally.  Eight weeks later he is referred to you for new crusting intranasally and worsened epistaxis.  What likely happened?    [Answer will be posted with next week's new question]

Answer to last week's question, "Put A Lid On It" (October 23, 2017)

Ectropion from lower lid scarring; a temporary lower lid suspension suture may be applied at the time of surgery to prevent this.