Surviving Sengstaken.

Aim of the Study To report the outcomes of children who underwent Sengstaken–Blakemore tube (SBT) insertion for life-threatening haemetemesis. Methods Single institution retrospective review (1997–2012) of children managed with SBT insertion. Patient demographics, diagnosis and outcomes were noted. Data are expressed as median (range). Main Results 19 children [10 male, age 1 (0.4–16) yr] were identified; 18 had gastro-oesophageal varices and 1 aorto-oesophageal fistula. Varices were secondary to: biliary atresia (n = 8), portal vein thrombosis (n = 5), alpha-1-anti-trypsin deficiency (n = 1), cystic fibrosis (n = 1), intrahepatic cholestasis (n = 1), sclerosing cholangitis (n = 1) and nodular hyperplasia with arterio-portal shunt (n = 1). Three children deteriorated rapidly and did not survive to have post-SBT endoscopy. The child with an aortooesophageal fistula underwent aortic stent insertion and subsequently oesophageal replacement. Complications included gastric mucosal ulceration (n = 3, 16%), pressure necrosis at lips and cheeks (n = 6, 31%) and SBT dislodgment (n = 1, 6%). Six (31%) children died. The remaining 13 have been followed up for 62 (2–165) months; five required liver transplantation, two underwent a mesocaval shunt procedure and 6 have completed endoscopic variceal obliteration and are under surveillance. Conclusions SBT can be an effective, albeit temporary, life-saving manoeuvre in children with catastrophic haematemesis. [ABSTRACT FROM AUTHOR]