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Am Surg 2019 Jan;85(1):e27-e30

Am Surg 2019 Jan;85(1):e27-e30

Acta Gastroenterol Belg 2018 Jul-Sep;81(3):447-448

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Clin Endosc 2018 Aug 29. Epub 2018 Aug 29.

Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea.

Balloon tamponade using Sengstaken-Blakemore (SB) tube is employed as a bridging therapy in cases in which endoscopic therapy fails to control esophageal variceal bleeding. Although SB tube insertion can lead to successful hemostasis, it is accompanied by numerous complications, with SB tube transection being one of the rarest complications. A 53-year-old man with liver cirrhosis and hepatocellular carcinoma presented with massive esophageal variceal bleeding. Read More

World J Gastroenterol 2018 Jul;24(28):3192-3197

Department of Surgery, Iwate Medical University, School of Medicine, Morioka, Iwate 020-0023, Japan.

Stent migration, which causes issues in stent therapy for esophageal perforations, can counteract the therapeutic effects and lead to complications. Therefore, techniques to regulate stent migration are important and lead to effective stent therapy. Here, in these cases, we placed a removable fully covered self-expandable metallic stent (FSEMS) in a 52-year-old man with suture failure after surgery to treat Boerhaave syndrome, and in a 53-year-old man with a perforation in the lower esophagus due to acute esophageal necrosis. Read More

Medicine (Baltimore) 2018 Jul;97(30):e11289

Nanjing Medical Univerity.

Rationale: Tracheal injury characterized by subcutaneous emphysema and dyspnea can occur following the use of a Sengstaken-Blakemore tube. Should tracheal injury occur, it may be possible to manage resultant airway obstruction with a tracheal stent.

Patient Concerns: We describe the case of a 51-year-old patient who developed a tracheal injury when a Sengstaken-Blakemore tube was inadvertently inserted into the patient's trachea. Read More

J Vis Surg 2018 9;4:93. Epub 2018 May 9.

Service of Surgery, Antequera Hospital, Málaga, Spain.

We present an alternative treatment to resolve lower gastrointestinal bleeding by the application of FloSeal, a haemostatic matrix. Fundamentally, the treatment consists of inserting the tube containing the Sengstaken-Blakemore probe impregnated with FloSeal into the rectum-sigma. This procedure is simple, easy to reproduce and can be very useful to control bleeding in the last section of the gastrointestinal tract. Read More

South Med J 2018 05;111(5):307-311

From the Division of Gastroenterology, Texas Tech University Health Sciences Center, El Paso, and Gastroenterology and Hepatology Section, Baylor College of Medicine, Houston, Texas.

Objectives: The Sengstaken-Blakemore (SB) tube is used in cases of uncontrolled variceal bleeding. Because of the complexity of the procedure and the lack of visualization, various techniques have been described to avoid blind placement. We report an innovative and simple technique for placement of the SB tube under direct endoscopic visualization. Read More

JA Clin Rep 2017 3;3(1):54. Epub 2017 Oct 3.

2Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, 162-8666 Japan.

Background: Esophageal submucosal hematoma is a rare complication after endovascular surgery. We report a case of an esophageal submucosal hematoma which may have been caused by rigorous cough during extubation.

Case Presentation: A 75-year-old woman underwent endovascular treatment for unruptured cerebral aneurysm under general anesthesia. Read More

Korean J Thorac Cardiovasc Surg 2018 Feb 5;51(1):76-80. Epub 2018 Feb 5.

Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center.

Early diagnosis followed by primary repair is the best treatment for spontaneous esophageal perforation. However, the appropriate management of esophageal leakage after surgical repair is still controversial. Recently, the successful adaptation of vacuum-assisted closure therapy, which is well established for the treatment of chronic surface wounds, has been demonstrated for esophageal perforation or leakage. Read More

Acute Med 2017 ;16(4):205

Trainee Representatives, Society for Acute Medicine.

The Specialist Advisory Committee (SAC) of June 2017 discussed the sign off of procedural competences relating to Sengstaken-Blakemore tube insertion and transvenous cardiac pacing and the application for chief registrar roles. Read More

J Med Case Rep 2017 Dec 10;11(1):343. Epub 2017 Dec 10.

Department of Radiology, Shizuoka General Hospital, 4-27-1 Kitaando, Aoi Ward, Shizuoka City, Shizuoka, 420-8527, Japan.

Background: In recent reports, re-irradiation with stereotactic body radiotherapy for lung tumors in patients previously treated with thoracic radiation therapy resulted in several serious toxicities. Serious non-lung toxicities were observed mostly in patients with central tumors, but we experienced a case of fatal gastric perforation after a second stereotactic body radiotherapy in a patient with a peripheral lung tumor.

Case Presentation: An 83-year-old Asian man was diagnosed with T2N0M0 lung cancer in the form of squamous cell carcinoma in the lower lobe of his left lung. Read More

BMC Gastroenterol 2017 Dec 8;17(1):148. Epub 2017 Dec 8.

Department of Gastroenterology, Lihuili Hospital of Ningbo Medical Center, 57# Xingning Road, Ningbo, 315000, China.

Background: Irritable bowel syndrome (IBS) is a common functional disease of the gastrointestinal tract. The current study aimed to examine the association between visceral hypersensitivity in IBS and cortical activation using functional magnetic resonance imaging (fMRI), and to elucidate the role of psychological factors in the pathogenesis of IBS.

Methods: The present study included 31 patients with IBS and 20 healthy controls. Read More

Korean J Intern Med 2018 07 10;33(4):696-704. Epub 2017 Nov 10.

Regional Cardiocerebrovascular Disease Center, Gyeongsang National University School of Medicine, Jinju, Korea.

Background/aims: The aim of this study was to investigate the mortality, bleeding control rate, and their associated predictors in patients treated with Sengstaken-Blakemore (SB) tube for uncontrolled variceal hemorrhage associated with hemodynamic instability or failure of endoscopic treatment.

Methods: The clinical data of 66 consecutive patients with uncontrolled variceal hemorrhage treated with SB tube at Gyeongsang National University Hospital from October 2010 to October 2015 were retrospectively analyzed.

Results: The overall success rate of initial hemostasis with SB tube was 75. Read More

Medicine (Baltimore) 2017 Jun;96(24):e7157

Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea.

This study was aimed to determine the risk factors of endoscopic variceal ligation-(EVL) induced ulcer bleeding.The prevalence of EVL-induced ulcer bleeding is reported to be 3.6%. Read More

AJP Rep 2017 Apr;7(2):e86-e92

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas.

 Uterine tamponade by fluid-filled balloons is now an accepted method of controlling postpartum hemorrhage. Available tamponade balloons vary in design and material, which affects the filling attributes and volume at which they rupture. We aimed to characterize the filling capacity and pressure-volume relationship of various tamponade balloons. Read More

Am J Emerg Med 2017 Oct 20;35(10):1500-1502. Epub 2017 Apr 20.

Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Anesthesia Critical Care and Pain Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA. Electronic address:

Background: Variceal hemorrhage is associated with high morbidity and mortality. A balloon tamponade device (BTD), such as the Sengstaken-Blakemore or Minnesota tube, may be used in cases of variceal hemorrhage. While these devices may be effective at controlling acute bleeding, the effect on patient outcomes remains less clear. Read More

BMJ Case Rep 2017 Mar 20;2017. Epub 2017 Mar 20.

Department of GI/Surgery, Galway University Hospitals Group, Galway, Ireland.

Surg Obes Relat Dis 2016 Sep - Oct;12(8):e63-e67. Epub 2016 Mar 3.

Surgical Department, Mansoura University, Mansoura, Egypt.

Endoscopy 2016 14;48 Suppl 1:E281-2. Epub 2016 Sep 14.

Digestive Endoscopy Center, The First Affiliated Hospital with Nanjing Medical University and Jiangsu Province Hospital, Nanjing, China.

Georgian Med News 2016 Apr(253):7-12

Tbilisi State Medical University the First University Clinic, Department of Surgery; Department of Internal Medicine; Department of Radiology, Tbilisi, Georgia.

Hypo-agenesis of the right lobe of the liver is an extremely rare finding. It is defined as the complete or partial absence of liver tissue on the right side without previous disease or surgery. It is usually an incidental finding. Read More

Pan Afr Med J 2016 29;23:55. Epub 2016 Feb 29.

Department of Thoracic Surgery, Hospital Universitario Nuestra Señora de Candelaria, Ctra, Del Rosario 145, 38010 Sta, Cruz de Tenerife, Spain.

Injury 2016 Sep 14;47(9):2048-50. Epub 2016 Mar 14.

Department of Anesthesiology, University of Florida College of Medicine, Gainesville, FL, USA. Electronic address:

Penetrating neck trauma can injure the major blood vessels, airway, gastrointestinal system, and neurological system. We present a case where a Sengstaken-Blakemore tube was emergently placed during surgical exploration of a stab wound to the neck to tamponade bleeding until surgical control was obtained and the vascular injuries were managed. Read More

World J Surg Oncol 2016 Feb 24;14:52. Epub 2016 Feb 24.

Gastroenterology and Hepatology, Kyoundo Hospital, Sasaki Institute, Tokyo, Japan.

Background: The outcomes of treatment of ruptured varices in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombus (PVTT) are unclear. We therefore evaluated the long- (rebleeding and death) and short-term (immediate death within 24 h of variceal bleeding diagnosis) outcomes of patients with PVTT who underwent emergency variceal band ligation.

Methods: Data on 62 patients with PVTT and endoscopically proven esophageal or gastric variceal bleeding from 2007 to 2012 were studied. Read More

Singapore Med J 2016 Feb;57(2):92-5; quiz 96

Department of Diagnostic Radiology, Changi General Hospital, Singapore.

Oesophageal rupture is a life-threatening complication of balloon tamponade for bleeding oesophageal varices. We herein describe the clinical course and imaging findings in a 33-year-old Indian man who had a Sengstaken-Blakemore (SB) tube inserted for uncontrolled haematemesis, which was unfortunately complicated by malposition of the gastric balloon with resultant oesophageal rupture. The inflated SB tube gastric balloon was visualised within the right hemithorax on chest radiography after the SB tube insertion. Read More

Curr Med Res Opin 2016 25;32(3):467-75. Epub 2016 Jan 25.

a Department of Faculty Surgery , South Ural State Medical University , Chelyabinsk , Russia.

Objective: Esophageal variceal bleeding is the most dangerous complication in patients with liver cirrhosis, and it is accompanied by high mortality. Their treatment can be complex, and requires a multidisciplinary approach. This review examines current approaches to the management of patients with liver cirrhosis who have acute esophageal variceal bleeding. Read More

Hepatology 2016 06 14;63(6):1957-67. Epub 2016 Jan 14.

Liver Unit, Hospital Clínic, Barcelona.

Unlabelled: Balloon tamponade is recommended only as a "bridge" to definitive therapy in patients with cirrhosis and massive or refractory esophageal variceal bleeding (EVB), but is frequently associated with rebleeding and severe complications. Preliminary, noncontrolled data suggest that a self-expandable, esophageal covered metal stent (SX-ELLA Danis; Ella-CS, Hradec Kralove, Czech Republic) may be an effective and safer alternative to balloon tamponade. We conducted a randomized, controlled trial aimed at comparing esophageal stent versus balloon tamponade in patients with cirrhosis and EVB refractory to medical and endoscopic treatment. Read More

Endoscopy 2016 Feb 13;48(2):184-7. Epub 2015 Oct 13.

Department of Surgery, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.

Background And Study Aims: A novel therapeutic concept, pressurized intraluminal aerosol chemotherapy (PILAC), and a corresponding device for distributing drugs to the mucosa and submucosa of the distal esophagus are presented.

Materials And Methods: The endoscopic device that was designed consisted of (i) a double-balloon catheter, similar to a Sengstaken-Blakemore tube; (ii) a carbon dioxide (CO2) line, used to create a gaseous, pressurized environment; and (iii) a micropump, used to generate a therapeutic aerosol. The device was inserted into the distal esophagus in three narcotized Landrace pigs. Read More

J Wound Care 2015 Jun;24(6 Suppl):S14-6

The Catholic University of Korea, Bucheon St. Mary's Hospital.

Many medical devices, such as pulse oximetry, ventilation masks and other splints are put on critically ill patients. Although these devices are designed to deliver relatively low physical pressure to the skin of the patient, they can still cause pressure ulcers (PUs) in critically ill patients. There are reports of medical device-related PUs on the face. Read More

J Med Case Rep 2015 Mar 4;9:50. Epub 2015 Mar 4.

Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Chenggong Rd., Neihu Dist., Taipei, 11490, Taiwan.

Introduction: Esophagogastric varices bleeding is a common complication due to portal hypertension in patients with liver cirrhosis. With the advancement of nonoperative management including vasoactive agents, endoscopic hemostasis or transjugular intrahepatic portosystemic shunt, surgical management has played a lesser role in recent decades. The present report describes a patient with hepatitis B (HBV)-related liver cirrhosis and portal vein thrombosis with recurrent esophagogastric varices bleeding despite the use of medical and endoscopic therapy. Read More

J Emerg Med 2015 Jul 30;49(1):40-2. Epub 2015 Mar 30.

Departments of Emergency Medicine and Internal Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, Michigan.

Background: With improvements in endoscopic and interventional radiologic therapies, insertion of gastroesophageal balloon tamponade catheters, commonly known as Sengstaken-Blakemore or Minnesota tubes, is a rarely performed procedure for esophageal or gastric variceal bleeding. In small hospitals or freestanding emergency departments, endoscopic or interventional radiology (IR) therapies might not be available, so patients with exsanguinating variceal bleeding must be stabilized or temporized for transport to larger hospitals. Occasionally, tamponade devices are necessary as a rescue therapy for failed endoscopic or IR therapies or can be used as definitive therapy in select cases. Read More

J Pediatr Surg 2015 Jul 24;50(7):1142-6. Epub 2014 Dec 24.

Department of Paediatric Surgery, Kings College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS. Electronic address:

Aim Of The Study: To report the outcomes of children who underwent Sengstaken-Blakemore tube (SBT) insertion for life-threatening haemetemesis.

Methods: Single institution retrospective review (1997-2012) of children managed with SBT insertion. Patient demographics, diagnosis and outcomes were noted. Read More

Nihon Shokakibyo Gakkai Zasshi 2014 Oct;111(10):2013-20

Department of Gastroenterology and Hepatology, Kyoto City Hospital.

A 54-year-old woman with hematemesis was referred to our hospital. She had a history of liver cirrhosis and diabetes mellitus. After inserting a Sengstaken-Blakemore tube, we performed endoscopic variceal ligation for ruptured esophageal varices. Read More

Gastroenterol Rep (Oxf) 2014 Nov 27;2(4):313-5. Epub 2014 Apr 27.

Division of Gastroenterology, McGill University, Jewish General Hospital, Montreal, Canada, Internal Medicine, McGill University, Jewish General Hospital, Montreal, Canada and Critical Care Medicine, McGill University, Jewish General Hospital, Montreal, Canada.

Non-variceal upper-gastrointestinal bleeding (NVUGIB) refractory to therapeutic endoscopy is a challenging situation. The following details a novel use for the Sengstaken-Blakemore tube in a case of severe ulcerative esophagitis after failure of conventional medical and endoscopic treatment. A 77-year-old man with a history of peptic ulcer disease developed massive hematemesis during a hospital admission. Read More

BMJ Case Rep 2014 Jan 20;2014. Epub 2014 Jan 20.

Department of Critical Care, Royal Infirmary of Edinburgh, Edinburgh, UK.

The use of Minnesota and modified Sengstaken-Blakemore tubes for balloon tamponade in acute variceal haemorrhage has declined with the availability of modern endoscopic techniques. However, in massive uncontrolled haemorrhage their use may still be required. They are very effective in controlling acute bleeding, but are associated with a range of potentially serious complications. Read More

Endoscopy 2013 13;45 Suppl 2 UCTN:E434. Epub 2013 Dec 13.

Department of Gastroenterology, Hospital Braga, Portugal.

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2013 Sep;25(9):554-5

Department of Critical Care Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, Guangdong, China.

Indian J Pediatr 2013 Apr 17;80(4):326-33. Epub 2013 Mar 17.

Department of Pediatrics Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.

Upper gastrointestinal bleeding (UGIB) is a potentially life threatening medical emergency requiring an appropriate diagnostic and therapeutic approach. Therefore, the primary focus in a child with UGIB is resuscitation and stabilization followed by a diagnostic evaluation. The differential diagnosis of UGIB in children is determined by age and severity of bleed. Read More

Surg Today 2014 Feb 6;44(2):363-5. Epub 2013 Mar 6.

Department of Surgery, Tainan Municipal Hospital, 670 Chung-Te Rd, Tainan, 701, Taiwan, ROC,

Acute esophageal necrosis, also called "black esophagus" because of its characteristic appearance on endoscopy, is a life-threatening disease; however, its temporal evolution on endoscopy is not well understood. We describe the serial changes in acute esophageal necrosis in two patients, who underwent four upper endoscopic examinations each. Serial endoscopy demonstrated progressive necrosis extending from the lower esophagus proximally to involve the middle or upper thoracic esophagus in both patients. Read More

Int J Colorectal Dis 2013 Nov 16;28(11):1595-6. Epub 2013 Jan 16.

Department of General Surgery, Thriassio General Hospital, Leoforos Genimata, Magoula, Athens, 19018, Greece,

Clin Privil White Pap 2012 Aug(27):1-14

BJOG 2013 Jan 13;120(1):5-14. Epub 2012 Aug 13.

Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.

Background: Effective interventions addressing postpartum haemorrhage (PPH) are critically needed to reduce maternal mortality worldwide. Uterine balloon tamponade (UBT) has been shown to be an effective technique to treat PPH in developed countries, but has not been examined in resource-poor settings.

Objectives: This literature review examines the effectiveness of UBT for the treatment and management of PPH in resource-poor settings. Read More

Trop Gastroenterol 2012 Jan-Mar;33(1):65-7

Department of General Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore

J Clin Gastroenterol 2012 Aug;46(7):613-9

Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Objectives: Hepatocellular carcinoma (HCC) is a common complication among patients with cirrhosis. Data are limited on the impact of HCC on in-hospital mortality from acute variceal hemorrhage (AVH) in patients with cirrhosis.

Methods: National in-hospital sample (1998 to 2007) was used to analyze admissions with AVH in cirrhotics to study impact of concomitant HCC on the in-hospital mortality. Read More

Indian J Gastroenterol 2013 Jul 6;32(4):227-31. Epub 2012 Jul 6.

Gastroenterology Department, Coimbra University Hospital, Praceta Mota Pinto, 3000-075 Coimbra, Portugal.

Background: Endoscopic injection of N-butyl-2-cyanoacrylate is the current recommended treatment for gastric variceal bleeding. Despite the extensive worldwide use, there are still differences related to the technique, safety, and long term-results. We retrospectively evaluated the efficacy and safety of cyanoacrylate in patients with gastric variceal bleeding. Read More

Forensic Sci Int 2012 Oct 19;222(1-3):e19-22. Epub 2012 Jun 19.

Department of Forensic Medicine, Faculty of Health Sciences, Aarhus University, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark.

We report six cases of lethal esophageal rupture following treatment with Sengstaken-Blakemore (SB) tube in management of acute variceal bleeding. Esophageal rupture is a known complication to SB tube treatment which unfortunately often is a result of iatrogenic misplacement of the tube. Our report indicates that despite additional guidelines to verify correct placement and new promising treatment modalities, lethal esophageal rupture still occurs. Read More

Contemp Nurse 2011 Oct;39(2):221-6

Department of Nursing, Charles Sturt University, Bathurst, NSW, Australia.

Acute oesophageal variceal haemorrhage is a major cause of death associated with cirrhotic liver disease. Whilst surgical procedures can decrease the risk of recurrent bleeds, pharmacological aids are often used to treat the cause of the varices: portal hypertension. Insertion of a Sengstaken Blakemore tube or Minnesota tube can temporarily halt the haemorrhage by exerting pressure on the varices. Read More

J Obstet Gynaecol Res 2012 May 9;38(5):903-4. Epub 2012 Apr 9.

J Nippon Med Sch 2012 ;79(1):19-30

Surgery for Organ Function and Biological Regulation, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.

Bleeding from esophageal varices (EVs) or gastric varices (GVs) is a catastrophic complication of chronic liver disease. In this paper, we review the management of bleeding EVs and GVs. DIAGNOSIS OF EVS AND GVS: The grading system for esophagogastric varices proposed by the Japan Society for Portal Hypertension classifies GVs into those involving the cardia (Lg-c), the fundus (Lg-f), and both the cardia and the fundus (Lg-cf). Read More

J Pediatr Surg 2011 Dec;46(12):2394-6

Department of Paediatric Surgery, Bristol Royal Hospital for Children, Bristol, UK.

Aortoesophageal fistula (AOF) in children with no history of cardiac disease or trauma is extremely rare, and survival is even rarer. We present a case of a 2-year-old boy who presented with massive hematemesis secondary to a primary aortoesophageal fistula and was found at endoscopy to have a submucosal hematoma. He then suffered a cardiac arrest with further catastrophic bleeding only controlled by a Sengstaken-Blakemore tube. Read More