Imperial College London
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ProfessorParisTekkis

Faculty of Medicine, Department of Surgery & Cancer

Professor of Colorectal Surgery
 
 
 
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Contact

 

+44 (0)20 3315 8529p.tekkis Website

 
 
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Location

 

Area DChelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Fadel:2020:10.1016/j.ijscr.2020.09.066,
author = {Fadel, MG and Boshier, PR and Howell, A-M and Iskandarani, M and Tekkis, P and Kontovounisios, C},
doi = {10.1016/j.ijscr.2020.09.066},
journal = {International Journal of Surgery Case Reports},
pages = {394--397},
title = {The management of acute lower gastrointestinal bleeding using a Sengstaken-Blakemore tube},
url = {http://dx.doi.org/10.1016/j.ijscr.2020.09.066},
volume = {75},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - IntroductionAcute lower gastrointestinal haemorrhage can potentially be life-threatening. We present a case of a massive rectal bleed which was managed successfully with a balloon tamponade device designed for upper gastrointestinal haemorrhage.Presentation of caseA 75-year-old gentleman, with a history of human immunodeficiency virus and cirrhosis with portal hypertension, presented with bright red rectal bleeding. Investigations showed a low haemoglobin level (74 g/L) and deranged clotting. Oesophago-gastro-duodenoscopy demonstrated no fresh or altered blood. Flexible sigmoidoscopy revealed active bleeding from a varix within the anterior rectal wall 4 cm from the anal verge. Efforts to stop the bleeding, including endoscopic clips, adrenaline injection and rectal packing, were unsuccessful and the patient became haemodynamically unstable. A Sengstaken-Blakemore tube was inserted per rectum and the gastric balloon was inflated to tamponade the lower rectum. The oesophageal balloon was then inflated to hold the gastric balloon firmly in place. A computed tomography angiogram demonstrated no evidence of haemorrhage with balloon tamponade. After 36 h, the balloon was removed with no further episodes of bleeding.DiscussionThe application of a balloon tamponade device should be considered in the management algorithm for acute lower gastrointestinal bleed. Advantages include its rapid insertion, immediate results and ability to measure further bleeding after the catheter has been placed.ConclusionSengstaken-Blakemore tube per rectum may effectively control massive low rectal bleeding when alternative methods have been unsuccessful.
AU  - Fadel,MG
AU  - Boshier,PR
AU  - Howell,A-M
AU  - Iskandarani,M
AU  - Tekkis,P
AU  - Kontovounisios,C
DO  - 10.1016/j.ijscr.2020.09.066
EP  - 397
PY  - 2020///
SN  - 2210-2612
SP  - 394
TI  - The management of acute lower gastrointestinal bleeding using a Sengstaken-Blakemore tube
T2  - International Journal of Surgery Case Reports
UR  - http://dx.doi.org/10.1016/j.ijscr.2020.09.066
UR  - http://hdl.handle.net/10044/1/83590
VL  - 75
ER  -
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