**Question:** A female who underwent laproscopic appendicectomy for acute appendicitis, on post op. day 2 bumped her nose on to a table. She developed difficulty in breathing and examination showed a swelling in the anterior part of the nasal septum. Next line of management is -

A. Nasal packing
B. Nasal steroid spray
C. Antibiotics
D. Antihistamines

**Correct Answer:** D. Antihistamines

**Core Concept:** The correct answer is related to the management of a patient who developed a nasal septal swelling after a nasal trauma. The swelling is likely due to a post-traumatic mast cell degranulation, causing histamine release and resulting in local inflammation and edema. Antihistamines are medications that work by blocking histamine receptors, reducing the effects of histamine and alleviating the symptoms of the nasal septal swelling.

**Why the Correct Answer is Right:** Antihistamines (Option D) are used in this scenario because they block the action of histamine, which is released in response to nasal trauma. By blocking histamine receptors, they reduce the effects of histamine and alleviate the symptoms of post-traumatic nasal septal swelling.

**Why Each Wrong Option is Incorrect:**

A. Nasal packing (Option A): This is inappropriate as it would worsen the swelling and cause further damage to the nasal mucosa.

B. Nasal steroid spray (Option B): While steroids can reduce inflammation, they are not indicated in this scenario as the patient has post-traumatic edema due to histamine release, not inflammation.

C. Antibiotics (Option C): Antibiotics are prescribed in bacterial infections, but in this case, the swelling is due to histamine release from mast cells, not bacterial infection.

**Clinical Pearl:** It is essential to consider the cause of the patient's symptoms when choosing the appropriate treatment. In this scenario, the patient has post-traumatic nasal septal swelling due to histamine release from mast cells. Antihistamines are the correct treatment option, while packing and steroid sprays are inappropriate due to the underlying cause, and antibiotics are not needed for a non-infectious condition.