Balloon Tamponade for the Management of Gastrointestinal Bleeding

J Emerg Med. 2022 Apr;62(4):545-558. doi: 10.1016/j.jemermed.2021.11.004. Epub 2022 Jan 20.

Abstract

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.

Discussion: Balloon tamponade is intended for hemodynamically unstable patients with massive gastrointestinal bleeding and inability to perform endoscopy, failed endoscopy, delay in endoscopy, or the need to stabilize before transfer. There are 3 main tamponade devices: the Linton-Nachlas tube, the Sengstaken-Blakemore tube, and the Minnesota tube. Each tamponade device has some unique features including the number of balloons and ports. We describe the technique with pearls and pitfalls for placement.

Conclusions: It is essential for emergency physicians to be familiar with balloon tamponade for acute gastrointestinal bleeding. We review the common balloon tamponade devices, and this article is intended to serve as a resource for those interested in expanding their knowledge of balloon tamponade. © 2022 Elsevier Inc.

Keywords: Linton–Nachlas tube; Minnesota tube; Sengstaken–Blakemore tube; balloon tamponade; esophageal varices; gastrointestinal bleeding.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Balloon Occlusion*
  • Endoscopy
  • Esophageal and Gastric Varices* / complications
  • Esophageal and Gastric Varices* / therapy
  • Gastrointestinal Hemorrhage / therapy
  • Humans