Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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A septal collection requires urgent drainage
A fluctuant reddish or purple septal swelling with new obstruction may be a haematoma; increasing pain, fever or systemic illness suggests secondary abscess.
Action: Arrange immediate ENT assessment and drainage as soon as possible. Do not defer care until fracture swelling settles or wait for routine imaging; suspected abscess also requires urgent antimicrobial and sepsis assessment.
Synopsis
Recognise an urgent septal collection after trauma or surgery, protect cartilage viability, and arrange drainage and infection treatment without avoidable delay.
Inspect the septum in every relevant nasal injury; an external examination alone can miss a dangerous internal collection.
A haematoma may obstruct one or both sides and can be confused with a pre-existing septal deviation.
Fluctuance rather than a firm structural bend supports a collection, assessed gently by an appropriately trained clinician.
Key red flags
New boggy septal swelling after nasal injury or surgery requires emergency ENT assessment, even without obvious external deformity.
Investigation priorities
01
Immediate nasal examinationFirst step
Identify a collection that changes the urgency of management.
Management branches
Suspected haematomaArrange drainage without delay
Recent nasal trauma or surgery is followed by a fluctuant septal swelling.
Contact ENT immediately and explain the suspected collection, obstruction and time course.
Assess and treat concurrent trauma or airway problems while arranging prompt specialist care.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.
ENT UK global nasal septal abscess guidanceSupplementary anatomy, microbiological sampling and source-control guidance; UK local antimicrobial pathways determine prescribing.