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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.
In cases of refractory bleeding, balloon tamponade with a Sengstaken–Blakemore tube may be necessary, or the use of a fully-covered esophageal self-expandable metallic stent, usually as a bridge to further endoscopy or treatment of the underlying cause of bleeding (i.e.: portal hypertension).
Tamponade of bleeding esophageal varices with a balloon; Application of photodynamic therapy for treatment of esophageal malignancies; Endoscopic drainage of pancreatic pseudocyst; Tightening the lower esophageal sphincter; Dilating or stenting of stenosis or achalasia; Percutaneous endoscopic gastrostomy (feeding tube placement)
This is typically in addition to endoscopic banding or sclerotherapy for the varices. [21] If this is sufficient then beta blockers and nitrates may be used for the prevention of re-bleeding. [21] If bleeding continues then balloon tamponade with a Sengstaken-Blakemore tube or Minnesota tube may be used in an attempt to mechanically compress ...
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 ...
This is in addition to endoscopic banding or sclerotherapy for the varices. [13] If this is sufficient then beta blockers and nitrates may be used for the prevention of re-bleeding. [13] If bleeding continues, balloon tamponade with a Sengstaken-Blakemore tube or Minnesota tube may be used in an attempt to mechanically compress the varices. [13]
The Sugiura procedure was originally developed to treat bleeding esophageal varices and consisted mainly of an esophagogastric devascularization. It was developed in Japan in 1973 [ 1 ] as a nonshunting technique that achieved variceal bleeding hemostasis by interrupting the variceal blood flow along the gastroesophageal junction.