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Balloon Tamponade for Variceal Bleeding
- Despite advances in pharmacology and endoscopy, placement of a balloon tamponade device is occasionally required to stabilize a patient with acute variceal bleeding.
- Currently, there are 3 devices available: the Linton-Nachlas (gastric balloon only), the Blakemore (gastric and esophageal balloons), and the Minnesota (gastric and esophageal balloons) tubes.
- The tube should initially be passed at least to the 50-cm mark and preferably to the maximum depth allowed by the length of the tube.
- Once the gastric balloon is inflated and correct position confirmed, traction must be applied to keep the gastric balloon engaged in the cardia and fundus of the stomach.
- An overhead pulley system is the preferred method to deliver traction. If you don't have weights for the pulley system, a 1-liter bag of crystalloid provides the desired 1.0 kg of traction.