Balloon tube tamponade for variceal bleeding: ten rules for safe usage

Keywords: oesophageal variceal bleeding, Sengstaken–Blakemore tube, balloon tamponade

Abstract

Acute gastro-oesophageal variceal bleeding can be controlled in most patients by a correctly placed Sengstaken–Blakemore or Minnesota balloon tube if endoscopic intervention fails or the necessary expertise is not immediately available.1 The temporary control of bleeding by balloon tamponade allows time for resuscitation and correction of clotting defects which should be done promptly to limit the duration of balloon tube compression, ideally within 24 hours. As 60% of patients will re-bleed after balloon deflation without further intervention, an experienced endoscopist must be available when the tube is removed. Although newer methods including self-expanding oesophageal stents can be used for bleeding control, balloon tamponade remains the most widely available technique for immediate control, especially in smaller hospitals.2

Author Biographies

J E J Krige, University of Cape Town

Surgical Gastroenterology and HPB Unit, Department of Surgery, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, South Africa

L Perold, University of Cape Town

Surgical Gastroenterology and HPB Unit, Department of Surgery, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, South Africa

E Jonas, University of Cape Town

Surgical Gastroenterology and HPB Unit, Department of Surgery, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, South Africa

Published
2021-12-08
How to Cite
Krige, J., Perold, L., & Jonas, E. (2021). Balloon tube tamponade for variceal bleeding: ten rules for safe usage. South African Journal of Surgery, 59(4), 198-199. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/3521
Section
How to do it