Balloon Tamponade Complications

Complications include:

• Oesophageal necrosis and perforation from inflation of the oesophageal balloon, or the gastric balloon in an incorrect position
• Aspiration if the airway is not secured first
• Mucosal ulceration from pressure (do not leave in situ for more than 24-36 hours, and periodically deflate and reinflate)
• Proximal migration of the tube causing airway obstruction
• Ongoing haemorrhage from incorrect insertion or position

Further treatment options if endoscopy fails include surgery, angiography and embolisation, or TIPSS. Transjugular Intrahepatic Porto-Systemic Shunt is a radiological intervention in which a connection is made between the portal and hepatic venous systems to reduce portal venous pressure. This procedure may be performed in patients with varices who continue to bleed despite other therapies.

Learning Bite

Balloon tamponade is an effective method of controlling a variceal haemorrhage until definitive intervention.