Document Detail

Esophageal perforation--associated risk with balloon tamponade after endoscopic therapy. Myth or reality?
MedLine Citation:
PMID:  16995456     Owner:  NLM     Status:  MEDLINE    
BACKGROUND/AIMS: Variceal bleeding is still associated with high mortality and balloon tamponade may be a lifesaving measure when endoscopic therapy is not available or feasible. The risk of esophageal perforation with balloon tamponade after endoscopic therapy is still uncertain. The aims of the study were to investigate balloon tamponade effectiveness and safety after endoscopic therapy.
METHODOLOGY: Retrospective analysis of 100 consecutive episodes of acute variceal bleeding treated with the Sengstaken-Blakemore tube.
RESULTS: Balloon tamponade had an overall effectiveness of 61%. The Child-Pugh score was significantly higher in patients who failed balloon tamponade. In 48 cases balloon tamponade was preceded by failure of endoscopic therapy. Balloon tamponade was more effective if a previous attempt to perform endoscopic therapy happened (75% vs. 48%; p = 0.006). Aspiration was the most frequent complication. No cases of esophageal perforation were registered.
CONCLUSIONS: Currently balloon tamponade is only used as a temporary bridge to other strategies, when other forms of hemostatic therapies do not succeed. Balloon tamponade was more effective in patients with less severe hepatic dysfunction. Previous attempts to perform endoscopic therapy may augment tamponade effectiveness without increasing the risk of esophageal perforation.
P Pinto-Marques; J M Romãozinho; M Ferreira; P Amaro; D Freitas
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  53     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2006 Jul-Aug
Date Detail:
Created Date:  2006-09-25     Completed Date:  2006-12-21     Revised Date:  2010-12-01    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  536-9     Citation Subset:  IM    
Gastroenterology Division, Hospital Garcia de Orta, Almada, Portugal.
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MeSH Terms
Balloon Dilation* / adverse effects,  methods
Balloon Occlusion*
Endoscopy, Digestive System / methods
Esophageal Perforation / epidemiology*,  mortality
Esophageal and Gastric Varices / therapy*
Gastrointestinal Hemorrhage / therapy*
Middle Aged

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