Search Our Scientific Publications & Authors

J Emerg Med 2022 04 20;62(4):545-558. Epub 2022 Jan 20.

Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois.

Background: Acute gastrointestinal bleeding is a potentially life-threatening condition that requires rapid intervention. In critically ill patients who are refractory to other therapies, balloon tamponade devices can be lifesaving.

Objective: We provide a review of balloon tamponade devices for gastric and esophageal variceal bleeding for emergency clinicians. Read More

BMC Gastroenterol 2021 Dec 3;21(1):452. Epub 2021 Dec 3.

Department of Thoracic Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 277# Yanta West Road, Xi'an, 710061, Shaanxi, China.

Background: The incidence of congenital bronchoesophageal fistulas in adults is rare. Most fistulas discovered in adulthood are often small and can be repaired with a simple one-step method.

Case Presentation: A 46-year-old female patient complained of a 2-month history of chocking, coughing, and a 12 kg drop in weight. Read More

Clin Liver Dis 2022 02 25;26(1):21-37. Epub 2021 Sep 25.

Division of Gastroenterology and Hepatology, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, USA.

Acute variceal bleeding is a complication of portal hypertension, usually due to cirrhosis, with high morbidity and mortality. There are 3 scenarios for endoscopic treatment of esophageal varices: prevention of first variceal bleed, treatment of active variceal bleed, and prevention of rebleeding. Patients with cirrhosis should be screened for esophageal varices. Read More

J Nippon Med Sch 2021 Sep 14. Epub 2021 Sep 14.

Department of Emergency and Critical Care Medicine, Nippon Medical School.

Background: Many invasive procedures are performed in the emergency room (ER), which have potential risks and complications. Due to limitations, especially with respect to size, portable X-ray devices are generally not used during such procedures. However, they have been miniaturized, enabling physicians to capture X-ray images by themselves. Read More

Cureus 2021 Jun 8;13(6):e15511. Epub 2021 Jun 8.

Gastroenterology, Sheffield Teaching Hospitals National Health Service (NHS) Foundation Trust, Sheffield, GBR.

Introduction An acute upper gastrointestinal bleed (AUGIB) is a fatal and prevalent medical emergency if not appropriately treated in a timely fashion. Aim The aim of this project was to compare the knowledge and skills of the participants in managing upper gastrointestinal bleeding (UGIB) before and after a one-day UGIB haemostasis course. Methods A one-day haemostasis course in line with the British Society of Gastroenterology's Endoscopy Quality Improvement Project Initiative was organised at the Sheffield Teaching Hospitals National Health Service (NHS) Trust. Read More

AEM Educ Train 2021 Jul 16;5(3):e10573. Epub 2021 Feb 16.

Department of Emergency Medicine Yale School of Medicine New Haven Connecticut USA.

Objective: Successful completion of life-saving procedures may benefit from a concise just-in-time (JIT) intervention. Video is an optimal medium for JIT training, but currently available video-based references are not optimized for a JIT format, especially in time-pressured situations prior to high-risk clinical contexts. We aimed to create and evaluate the efficacy of a brief video review of emergent Sengstaken-Blakemore tube (SBT) insertion for acutely decompensating variceal hemorrhage when used just prior to clinical performance in a simulated setting. Read More

Cureus 2021 Mar 17;13(3):e13946. Epub 2021 Mar 17.

Department of Gastroenterology, "Elias" Emergency University Hospital, Bucharest, ROU.

In rare instances, rectal cleansing enemas may cause rectal injury, precipitating lower gastrointestinal hemorrhage (LGIH). In a subset of LGIH cases, the bleeding diathesis may fail to respond to traditional treatment modalities and can be life-threatening. We present a case of an 84-year-old female with cleansing enema induced rectal bleeding - she was a poor surgical candidate and due to lack of access to in-house interventional radiology teams, hemostasis was attempted with sui generis use of the Sengstaken-Blakemore tube. Read More

Clin Exp Emerg Med 2021 Mar 31;8(1):65-70. Epub 2021 Mar 31.

Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea.

Objective: Intractable massive oronasal bleeding can become a life-threatening condition. The success rate of conventional bleeding control methods other than transarterial embolization (TAE) is not expected to be high. We investigated the efficacy of Sengstaken-Blakemore tube (SBT) balloon tamponade in patients with sustained and intractable oronasal bleeding secondary to facial injury. Read More

Intensive Care Med 2021 06 9;47(6):702-703. Epub 2021 Mar 9.

AP-HP, Hôpital Louis Mourier, Médecine intensive Réanimation, 92700, Colombes, France.

Rev Esp Enferm Dig 2021 Sep;113(9):687

Aparato Digestivo, Complexo Hospitalario Universitario A Coruña.

A 50-year-old patient with a history of hypopharyngeal cancer, laryngectomy, adjuvant chemoradiotherapy and incompetent tracheoesophageal fistula was admitted for elective pharingostomal surgery. During the surgery, he presented esophageal bleeding with hemodynamic instability. After stabilization, a gastroscopy was performed through the stoma, showing arterial bleeding 4-5 cm distal to the stoma, which was controlled with three hemostatic clips. Read More

World J Clin Cases 2021 Jan;9(2):372-378

Department of Anesthesiology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China.

Background: Massive esophageal variceal bleeding can be catastrophic, leading to high morbidity and mortality. Patients experiencing massive esophageal variceal bleeding are at high risk of aspiration and hemorrhagic shock in acute episodes. Intubation and bleeding control are the two essential steps for resuscitation of these patients. Read More

BMJ Case Rep 2020 Dec 21;13(12). Epub 2020 Dec 21.

Department of Radiology, Maastricht University Medical Centre+, Maastricht, Limburg, The Netherlands

A 31-year-old woman with hepatocellular carcinoma suffered from recurrent oesophageal variceal bleeding due to portal hypertension, which was caused by severe compression of the portal vein by metastatic lymph nodes. Endoscopic band ligation and pharmacological treatment did not suffice to prevent recurrence of variceal bleeding. Eventually, after the fifth variceal bleeding within 6 months, the patient was admitted to the intensive care unit in a haemodynamic shock. Read More

J Surg Case Rep 2020 Sep 30;2020(9):rjaa385. Epub 2020 Sep 30.

Division of Thoracic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.

Esophageal perforation in liver transplant recipients is a rare phenomenon. We herein report a case of an esophageal perforation due to Sengstaken-Blakemore tube in a liver-transplant recipient diagnosed 6 weeks post-transplant. A 2. Read More

Int J Surg Case Rep 2020 21;75:394-397. Epub 2020 Sep 21.

Department of Colorectal Surgery, Chelsea and Westminster Hospital, London, United Kingdom; Department of Surgery and Cancer, Imperial College, London, United Kingdom; Department of Colorectal Surgery, Royal Marsden Hospital, London, United Kingdom. Electronic address:

Introduction: Acute lower gastrointestinal haemorrhage can potentially be life-threatening. We present a case of a massive rectal bleed which was managed successfully with a balloon tamponade device designed for upper gastrointestinal haemorrhage.

Presentation Of Case: A 75-year-old gentleman, with a history of human immunodeficiency virus and cirrhosis with portal hypertension, presented with bright red rectal bleeding. Read More

Kyobu Geka 2020 Jul;73(7):547-551

Department of Thoracic Surgery, Aomori Prefectural Central Hospital, Aomori, Japan.

Background: Tracheobronchial injury is often operated urgently because of the risk of high mortality. However, small injuries can recover by conservative management.

Case: A 65-year-old man was treated for esophageal varix with transcatheter arterial embolization therapy. Read More

Clin J Gastroenterol 2020 Oct 25;13(5):693-696. Epub 2020 Jun 25.

Department of Gastroenterology, Sendai Kousei Hospital, 4-15, Hirose-machi, Aoba-ku, Sendai, Miyagi, 980-0873, Japan.

MitraClip procedure is an effective treatment for mitral regurgitation, performed globally. During the MitraClip procedure, transesophageal echocardiography is an essential modality to perform the operation safely. Although a few transesophageal echocardiography-related complications, such as esophageal hematoma, have been reported, there are no reports on massive esophageal bleeding after the MitraClip procedure. Read More

ACG Case Rep J 2019 Dec 25;6(12):e00296. Epub 2019 Dec 25.

Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO.

Gastrointestinal bleeding is an uncommon but potentially life-threatening complication of laparoscopic adjustable gastric banding (LAGB) erosion. We present the use of a Sengstaken-Blakemore tube as a treatment device for severe gastrointestinal bleeding secondary to persistent LAGB erosion. A 72-year-old woman post-LAGB placement presented with hemorrhagic shock from gastric band erosion that was not responsive to endoscopic and angiographic interventions. Read More

Case Rep Surg 2019 29;2019:6146125. Epub 2019 Aug 29.

Liver Transplant Unit, Department of General Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain.

The surgical procedure for orthotopic liver transplantation (OLT) is well standardized, and most groups use the retrohepatic caval preservation or piggyback technique to improve hemodynamic tolerance. However, when a discrepancy between the site in the right upper quadrant of the liver recipient and a small graft is present, this technique can provoke a rotation on the axis of the vena cava and cause an occlusion of the suprahepatic vein drainage. This problem can be detected intraoperatively, and several methods have been described to resolve it by placing different devices to correct the position. Read More

BMJ Case Rep 2019 May 14;12(5). Epub 2019 May 14.

Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.

Oesophageal balloon tamponade tubes are a rare cause of ST-segment elevation (STE), thought to result from extrinsic compression of coronary arteries. This case describes STE following the use of a Sengstaken-Blakemore tube (SBT) under traction for management of bleeding oesophageal varices during orthotopic liver transplantation. This case is the first to report a significant troponin rise with STE indicative of myocardial injury following the use of SBT. Read More

Am Surg 2019 Mar;85(3):e179-e181

J Clin Transl Hepatol 2019 Mar 10;7(1):32-39. Epub 2019 Mar 10.

Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.

The management of post-endoscopic variceal ligation (EVL) bleeding ulcers (PEBUs) is currently based on local expertise and patients liver disease status. The present retrospective study investigated associations between the endoscopic morphology of PEBUs and patient outcomes. Patients underwent EVL (primary or secondary), from January 2015 to January 2018, in two tertiary care hospitals in India (ILBS New Delhi and Dharamshila Narayana New Delhi). Read More

Am Surg 2019 Feb;85(2):e108-e110

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 2019 Mar 29;52(2):182-185. 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 Institute of Digestive Endoscopy and Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University, Nanjing, PR China.

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