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The Change Caused by 1:5000 Epinephrine Spraying

Before spraying

1 min. after spraying

3 min. after spraying

5 min. after spraying

Comment:

3 to 5 minutes after spraying 1:5000 epinephrine into the nasal cavity for a few seconds, constriction of the deeper vessels in the nasal mucosa was identified with NBI.

Images and comments by Dr. S. Takano <ENF-V2>

Right Epistaxis (Thrombocytopenia) Aged 80, male

white light

NBI

Comment:

The white light imaging suggested that the right epistaxis was bleeding from the middle meatus side of the middle nasal turbinate, and NBI was used to identify the deeper vessels.

Images and comments by Dr. S. Takano <ENF-V2>

Right Epistaxis (Hypertensive Epistaxis) Aged 81, male

white light

NBI

white light

NBI

Comment:

Hypertensive epistaxis on the 2nd day after onset. The suspected bleeding region was identified on nasal septum with NBI before epinephrine spraying. However, 5 minutes after epinephrine spraying, it was possible to identify the bleeding region more clearly.

Images and comments by Dr. S. Takano <ENF-V2>

Right Epistaxis (Hypertensive Epistaxis) Aged 72, male

white light

NBI

Comment:

The patient came to us reporting repeated epistaxis since the previous day. The bleeding was from the middle nasal turbinate. The vessels were identified clearly with white light imaging and NBI.
Bipolar cauterization succeeded in the hemostasis.

Images and comments by Dr. S. Takano <ENF-V2>