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An 86-year-old woman had a history of cirrhosis associated with chronic hepatitis B infection lasting more than 16 years; she had had five episodes of esophageal variceal bleeding that had required placement of a Sengstaken–Blakemore tube for tamponade and had undergone subsequent sclerotherapy. The patient presented to the emergency department with a new episode of hematemesis, and a Sengstaken–Blakemore tube was placed. Subsequently, the patient had pain in the left chest area, and chest radiography showed a malpositioned gastric balloon (Panel A). Computed tomography of the chest showed that the tube had penetrated the esophageal wall (arrow, Panel B), with . . . [Full Text of this Article] |
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