Tube Compression of the Esophagus and Stomach

Overview :

One emergency method of stopping bleeding from esophageal varices is to tamponade it with a balloon. The Sengstaken-Blakemore tube is a complex rubber device with two balloons and three channels—one channel for each balloon and one that goes all the way through. The Minnesota tube has four channels, an extra one that opens above the first balloon. The bottom balloon is round; the upper balloon is long and narrow. The tube is passed through the nose or mouth into the stomach, where the bottom balloon is inflated. Then the tube is pulled back until the bottom balloon comes up against the narrow valve at the top of the stomach, when it can go no further. At this point, the upper balloon is inflated, putting pressure on a length of esophagus where the bleeding veins are located. The tube is then fixed so it cannot be dislodged. The third channel in the tube is used to aspirate (suck out) stomach contents to see if the bleeding has stopped. The fourth channel aspirates from the esophagus.

These tubes are a temporary measure. They stabilize the patient until bleeding has stopped, blood transfusions are received, and permanent repair is imminent.

Since the lower balloon effectively separates the esophagus from the stomach, it is possible to determine more accurately where the bleeding is located when it is in place.

This method of treating upper intestinal bleeding is being replaced by procedures that use a gastroscope, a flexible device that permits viewing and operating without surgery.