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Case Reports
. 2017 Dec;4(4):141-143.
doi: 10.1016/j.ijpam.2017.10.001. Epub 2017 Dec 23.

Sengstaken-Blakemore Tube: an extra mile

Tawfiq Taki Al Lawati  1 , Yahya Al Brashdi  1 , Najwa Al Rahbi  1 , Ibrahim Omar  1 , Suad Al Ismaili  1
Affiliations
Case Reports

Sengstaken-Blakemore Tube: an extra mile

Tawfiq Taki Al Lawati et al. Int J Pediatr Adolesc Med. 2017 Dec.

Abstract

Upper gastrointestinal bleeding (UGIB) in children has multiple etiologies but fortunately is not encountered commonly by pediatricians. Aorto-esophageal fistula (AEF) in children is a rare cause of UGIB and it is mainly secondary to accidental ingestion of foreign bodies, particularly disc batteries, or after cardiothoracic surgery. In this study, we report a case of a 3-year-old child who developed de novo AEF with no prior injury to the esophagus. The child presented with massive UGIB leading to hypovolemic shock, acute kidney injury, and cardiac arrest. The torrential bleed was controlled using a Sengstaken-Blakemore Tube (SBT), which allowed urgent chest CT angiography as well as subsequent thoracotomy and repair of the fistula Unfortunately, the child succumbed to repeated cardiac arrests secondary to the renal injury and severe acidosis. This case highlights the need for the early recognition of massive UGIB in children and the requirement to make appropriately sized SBTs available in all pediatric gastroenterology units.

Keywords: Aorto-esophageal fistula; Children; Sengstaken–Blakemore tube; Upper gastrointestinal bleed.

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Figures

Fig. 1
Fig. 1
Axial contrast-enhanced CT of the chest showing a linear enhanced structure arising from the anterior mid-thoracic aorta, where the “arrowhead” represents the aorto-esophageal fistula. Note the inflated Sengstaken–Blakemore tube within the mid-esophagus, as indicated by the “arrowed circle”.
Fig. 2
Fig. 2
Sagittal reformat based on contrast-enhanced CT of the chest indicating a linear enhanced structure arising from the anterior mid-thoracic aorta where the “arrowhead” represents the aorto-esophageal fistula.
See this image and copyright information in PMC

References

    1. Pant C., Sankararaman S., Deshpande A., Olyaee M., Anderson M.P., Sferra T.J. Gastrointestinal bleeding in hospitalized children in the United States. Curr Med Res Opin. 2014 Jun;30(6):1065–1069. - PubMed
    1. Lacroix J., Nadeau D., Laberge S., Gauthier M., Lapierre G., Farrell C.A. Frequency of upper gastrointestinal bleeding in a pediatric intensive care unit. Crit Care Med. 1992;20:35. - PubMed
    1. Attard Thomas M., Miller Mikaela, Pant Chaitanya, Kumar Ashwath, Thomson Mike. Mortality associated with gastrointestinal bleeding in children: a retrospective cohort study. World J Gastroenterol. 2017 Mar 7;23(9):1608–1617. - PMC - PubMed
    1. Richard A., Lirio M.D. Management of upper gastrointestinal bleeding in children: variceal and nonvariceal. Gastrointest Endosc Clin N Am. 2016;26:63–73. - PubMed
    1. Hussey S., Howard E.R., Mowat A.P. Prospective study of major upper gastrointestinal hemorrhage in children [abstract] Can J Gastroenterol. 2008;22(A):156A.

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