General

Self-Expandable Metallic Stents Vs. Sengstaken–Blakemore tube for acute Variceal Bleeding

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8 Jul 2016 - General
 

Oesophageal Varices and Gastric Varices are the complications of portal hypertension, with the underlying liver cirrhosis. Hematemesis, and/or malaena are the presenting complaint for variceal haemorrhage. The treatment options for variceal bleeding, can range from medication like terlipressin, endoscopy intervention, ballon tamponade, transjugular intrahepatic portosystemic shunt placement. Sengstaken-Blakemore tube is effective in short term control for acute and massive variceal bleeding, to stabilized or control the bleeding temporary, for a more definite endosocpy treatment. A new special designed removable covered self-expandable metallic stents was developed for the treatment of oesophageal varrices has become available. It can acheive hemostasis of varices bleeding by direct compression of the bleeding oesophageal varices. Its application may be less complicated comparing to sengstaken-blakemore tube. Anyone has any experience in using self-expandable metalic stent for acute massive oesophageal varices bleed?? Its seem like a great alternative for sengstaken-blakemore tube...

Actually I haven’t used Self-Expandable Metallic Stents for control of acute severe variceal bleeding, as this is quite a new device on the market. Have been using Sengstaken-Blakemore tubes on few occasions for some severe persistent, unstable variceal bleeding, and patient need to be intubated to protect the airway prior to insertion of Senstaken-Blakemore tube. The application of Self-Expandable Metallic Stents seem more attractive comparing to sengstaken-Blakemore tube. I would see roughly a...
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I guess you are the only person with oesophageal stent here. What is the benefit of the self expandable metallic stent vs Sengstaken-Blakemore ?The rate of aspiration during placement, the risk of stent migration, pressure necrosis and oesophageal ulcer. Just for curiosity sake, how many acute variceal bleeding do you see per year. I am glad as a primary physician, I do not get to see them and they do not walk through my door. If one day, a patient with known portal hypertension walk through m...
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