Austin Health

Title
Inferolateral ST-segment elevation with use of Sengstaken-Blakemore tube for variceal bleeding during orthotopic liver transplantation.
Publication Date
2019-05-14
Author(s)
Garbett, Luke
O'Conghaile, Stiofan
Pillai, Parameswan
Subject
anaesthesia
cirrhosis
gastrointestinal surgery
transplantation
varices
Type of document
Journal Article
OrcId
0000-0002-5407-9864
DOI
10.1136/bcr-2018-228000
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.
Link
Citation
BMJ Case Reports 2019; 12(5): e228000
Jornal Title
BMJ Case Reports

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