Clin Endosc.  2019 Mar;52(2):182-185. 10.5946/ce.2018.076.

Endoscopic Removal of Inflated Transected Sengstaken–Blakemore Tube Using Endoscopic Scissors

• Lee JH
• Hwang EK
• Doeun C
• Yoo JJ
• Kim SG
• Kim YS

• KMID: 2447676
• DOI: http://doi.org/10.5946/ce.2018.076

Abstract

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. Therapeutic endoscopic variceal ligation failed, and SB tube was inserted. The SB tube was unexpectedly disconnected because of the patient's irritability due to hepatic encephalopathy. The esophageal and gastric balloon of the SB tube remained inflated in the stomach. Whereas the use of other endoscopic instruments was ineffective, endoscopic removal was successfully accomplished using endoscopic scissors. In conclusion, we detected SB tube transection in a patient with hepatic encephalopathy and removed remnants of the inflated tube using endoscopic scissors.

Keyword

Sengstaken–Blakemore tube; Transection; Impaction; Endoscopic scissors

MeSH Terms

Balloon Occlusion
Carcinoma, Hepatocellular
Esophageal and Gastric Varices
Gastric Balloon
Hemostasis
Hepatic Encephalopathy
Humans
Ligation
Liver Cirrhosis
Middle Aged
Stomach

Figure

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  Fig. 1. (A, B) Deflation of impacted esophageal and gastric balloon transected from the Sengstaken–Blakemore tube using endoscopic scissors.

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  Fig. 2. (A) Deflated esophageal and gastric balloon extracted outside. (B) Transected remnant tube excluding esophageal and gastric balloon. (C) Entire transection of the Sengstaken–Blakemore tube.

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