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Title: Inferolateral ST-segment elevation with use of Sengstaken-Blakemore tube for variceal bleeding during orthotopic liver transplantation.
Austin Authors: Garbett, Luke ;O'Conghaile, Stiofan ;Pillai, Parameswan 
Affiliation: Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 14-May-2019
Date: 2019-05-14
Publication information: BMJ Case Reports 2019; 12(5): e228000
Abstract: Oesophageal balloon tamponade tubes are a rare cause of ST-segment elevation (STE), thought to result from extrinsic compression of coronary arteries. This case describes STE following the use of a Sengstaken-Blakemore tube (SBT) under traction for management of bleeding oesophageal varices during orthotopic liver transplantation. This case is the first to report a significant troponin rise with STE indicative of myocardial injury following the use of SBT. Interestingly, we found that releasing traction from the SBT resulted in resolution of STE within minutes, suggesting that SBT traction may reversibly impede coronary perfusion. We recommend vigilant monitoring of patients following SBT insertion and for clinicians to consider that SBT traction may impair coronary perfusion and result in myocardial injury in patients without pre-existing coronary artery disease.
DOI: 10.1136/bcr-2018-228000
ORCID: 0000-0002-5407-9864
Journal: BMJ Case Reports
PubMed URL: 31092493
Type: Journal Article
Subjects: anaesthesia
gastrointestinal surgery
Appears in Collections:Journal articles

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