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2 results

  • 28 - Gastrointestinal Bleeding

  • from Section 6 - Gastrointestinal Emergencies
  • Edited by Kaushal Shah, Weill Cornell Medical Center, New York, Jarone Lee, Massachusetts General Hospital, Boston
  • Edited in association with Clark G. Owyang, Weill Cornell Medical Center, New York, Benjamin Christian Renne, Massachusetts General Hospital, Boston
  • Book:
    Practical Emergency Resuscitation and Critical Care
    Published online:
    02 November 2023
    Print publication:
    23 November 2023, pp 257-269

  • Summary

    Upper gastrointestinal bleeding (UGIB) is bleeding proximal to the ligament of Treitz (esophageal, gastric or duodenal source). More common than lower gastrointestinal bleeding (LGIB; approximately 70% of GIB). Most common cause is peptic ulcer disease. LGIB is bleeding distal to the ligament of Treitz. Lower gastrointestinal bleeding is less common than UGIB (approximately 30% of GIB). LGIB has lower mortality rate than UGIB. The most common cause is diverticular disease.

  • 5.4.2 - Sengstaken–Blakemore Tube Insertion

  • from Section 5.4 - Practical Gastrointestinal System
  • Edited by Ned Gilbert-Kawai, The Royal Liverpool Hospital, Debashish Dutta, Princess Alexandra Hospital NHS Trust, Harlow, Carl Waldmann, Royal Berkshire Hospital, Reading
  • Book:
    Intensive Care Medicine
    Published online:
    27 July 2023
    Print publication:
    01 December 2021, pp 614-616

  • Summary

    Key Learning Points

    1. 1. A Sengstaken–Blakemore tube (SBT) should only be employed as a rescue technique.

    2. 2. In practice, the four-lumen Minnesota tube is often encountered, not a classical SBT. However, insertion and aftercare are the same.

    3. 3. In most cases, only the gastric balloon will need inflating.

    4. 4. Monitor pressures regularly, and be careful to avoid complications.

    5. 5. An SBT is only a temporising measure, and having inserted one, it is vital to make a definitive management plan early.