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September 8, 1978

Overdistension of the Gastric BalloonComplication With the Sengstaken-Blakemore Tube

Author Affiliations

From the Gastroenterology Service, Department of Medicine, Fitzsimons Army Medical Center, Denver.

JAMA. 1978;240(11):1172-1173. doi:10.1001/jama.1978.03290110070023

HEMORRHAGE from gastric or esophageal varices often necessitates the use of a Sengstaken-Blakemore tube for variceal tamponade. Although complications may occur with its use, safety and effectiveness following proper placement and monitoring have been demonstrated in 91% of patients.1,2 We report a case of overinflation of the Sengstaken-Blakemore gastric balloon while following optimal recommended inflation and pressure monitoring techniques.

Report of a Case  A 51-year-old woman was admitted to Fitzsimons Army Medical Center with upper gastrointestinal hemorrhage from esophageal varices confirmed by emergency esophagogastroduodenoscopy. A new Sengstaken-Blakemore tube with Boyce1 modification was inflated and inspected under water to ensure competency of both esophageal and gastric balloons and was then inserted through the mouth without difficulty. The gastric balloon was filled with 100 ml of air, and firm traction was applied on the tube at the mouth to position the gastric balloon against the diaphragm at the gastric cardia. An