Conservative Treatment: Balloon Tamponade
Balloon tamponade treatment for bleeding from esophagogastric varices with the Sengstaken-Blakemore (S-B) tube or Linton-Nachlas (L-N) tube was established in the 1950s. Now, after emergency endoscopy, the S-B tube is generally used for bleeding esophageal varices and the L-N tube is used for bleeding gastric varices. Because balloon tamponade with the S-B-tube is significantly inferior to endoscopic injection sclerotherapy (EIS) in the control of bleeding esophageal varices, the current indication for balloon tamponade is uncontrollable hemorrhage from esophagogastric varices caused by endoscopic treatments such as EIS. The contraindication is an anatomical abnormality in the esophagus such as esophageal stenosis, and careful use is required in patients with previous endoscopic treatments such as EIS. Balloon tamponade achieves primary hemostasis of variceal bleeding in 90% of the episodes and remains a clinically important modality even now.
KeywordsBalloon tamponade Bleeding esophagogastric varices Sengstaken-Blakemore tube Linton-Nachlas tube Endoscopic injection sclerotherapy
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