868 The management of acute lower gastrointestinal bleeding using a Sengstaken-Blakemore tube

Abstract Introduction Acute lower gastrointestinal haemorrhage can potentially be life-threatening. We present a case of massive rectal bleed which was managed successfully with balloon tamponade device designed for upper haemorrhage. Presentation A 75-year-old gentleman, history human immunodeficiency virus and cirrhosis portal hypertension, presented bright red bleeding. Investigations showed low haemoglobin level (74 g/L) deranged clotting. Oesophago-gastro-duodenoscopy demonstrated no fresh or altered blood. Flexible sigmoidoscopy revealed active bleeding from varix within the anterior wall 4 cm anal verge. Efforts to stop bleeding, including endoscopic clips, adrenaline injection packing, were unsuccessful patient became haemodynamically unstable. Sengstaken-Blakemore tube inserted per rectum gastric inflated rectum. The oesophageal then hold firmly in place. computed tomography angiogram evidence tamponade. After 36 h, removed further episodes Discussion application should considered management algorithm acute bleed. Advantages include its rapid insertion, immediate results ability measure after catheter has been placed. Conclusions may effectively control when alternative methods have unsuccessful.