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Inferolateral ST-segment elevation with use of Sengstaken-Blakemore tube for variceal bleeding during orthotopic liver transplantation
  1. Luke Garbett,
  2. Stiofan O’Conghaile and
  3. Parameswan Pillai
  1. Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
  1. Correspondence to Dr Luke Garbett, lukebgarbett{at}


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.

  • anaesthesia
  • varices
  • cirrhosis
  • gastrointestinal surgery
  • transplantation
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  • Contributors LG: involved in conception and design, interpretation of data, drafting and revision of paper, final approval of content, agreement to be accountable for the article. SO and PP: involved in conception and design, drafting and revision of paper, final approval of content, agreement to be accountable for the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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