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Minnesota four-lumen tube, with esophageal and gastric balloons, and esophageal and gastric aspirates. Balloon tamponade is considered a bridge to more definitive treatment modalities, and is usually administered in the emergency department or in the intensive-care unit setting, due to the illness of patients and the complications of the procedure.
A traction of 1 kg is applied to the tube so that the gastric balloon will compress the gastroesophageal junction and reduce the blood flow to esophageal varices. If the use of traction alone cannot stop the bleeding, the esophageal balloon is also inflated to help stop the bleeding.
Esophageal varices seven days after banding, showing ulceration at the site of banding. The upper two thirds of the esophagus are drained via the esophageal veins, which carry deoxygenated blood from the esophagus to the azygos vein, which in turn drains directly into the superior vena cava.
Peri-arrest treatment includes giving IV fluids and blood transfusions, and controlling the source of any bleeding - by direct pressure for external bleeding, or emergency surgical techniques such as esophageal banding, gastroesophageal balloon tamponade (for treatment of massive gastrointestinal bleeding such as in esophageal varices ...
Cutting off of larger pieces of tissue with a snare device (e.g., polyps, endoscopic mucosal resection) Application of cautery to tissues; Removal of foreign bodies (e.g., food) that have been ingested; Tamponade of bleeding esophageal varices with a balloon; Application of photodynamic therapy for treatment of esophageal malignancies
Once devascularization is complete, the esophagus is clamped in two areas with esophageal clamps, and esophageal transection is done at the level of the diaphragm. The anterior muscular and mucosal layers are divided, but the posterior layer is left intact. Sutures are then placed and the divided varices are occluded.
Tamponade is a useful method of stopping a hemorrhage. This can be achieved by applying an absorbent dressing directly into a wound, thereby absorbing excess blood and creating a blockage, or by applying direct pressure with a hand or a tourniquet. Not to be confused with a tamponade that occurs as a result of health problems.
The esophageal veins drain blood from the esophagus to the azygos vein, in the thorax, and to the inferior thyroid vein in the neck. It also drains, although with less significance, to the hemiazygos vein , posterior intercostal vein and bronchial veins .