Kogilathota Jagirdhar GS, Okafor CC, Hussain M, Elmati PR, Ghumman A, Shah M, Surani S. Decline of the Sengstaken-Blakemore tube: A review of shifting practices in gastrointestinal hemorrhage management. World J Crit Care Med 2025; 14(3): 101856 [DOI: 10.5492/wjccm.v14.i3.101856]
Corresponding Author of This Article
Salim Surani, MD, FACP, FCCP, Professor, Department of Medicine and Pharmacology, Texas A and M University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Crit Care Med. Sep 9, 2025; 14(3): 101856 Published online Sep 9, 2025. doi: 10.5492/wjccm.v14.i3.101856
Decline of the Sengstaken-Blakemore tube: A review of shifting practices in gastrointestinal hemorrhage management
Gowthami Sai Kogilathota Jagirdhar, Chiamaka C Okafor, Muhammad Hussain, Praveen Reddy Elmati, Aleena Ghumman, Mehul Shah, Salim Surani
Gowthami Sai Kogilathota Jagirdhar, Muhammad Hussain, Mehul Shah, Department of Gastroenterology, Saint Michaels Medical Center, Newark, NJ 07104, United States
Chiamaka C Okafor, Department of Medicine, University of Texas Medical Branch, Galveston, TX 77550, United States
Praveen Reddy Elmati, Department of Anesthesiology, Saint Clair Hospital, Dover, NJ 07801, United States
Aleena Ghumman, Department of Medicine, University of California, Santa Barbara, CA 93106, United States
Salim Surani, Department of Medicine and Pharmacology, Texas A and M University, College Station, TX 77843, United States
Author contributions: Kogilathota Jagirdhar GS and Elmati PR designed the overall concept and outline of the manuscript; Kogilathota Jagirdhar GS, Okafor C, Hussain M, Elmati PR and Ghumman A performed the research and analyzed the data; Kogilathota Jagirdhar GS, Okafor C, Hussain M, Elmati PR, Ghumman A, Shah M, and Surani S contributed to the manuscript’s writing and editing; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Salim Surani, MD, FACP, FCCP, Professor, Department of Medicine and Pharmacology, Texas A and M University, 40 Bizzell Street, College Station, TX 77843, United States. srsurani@hotmail.com
Received: September 28, 2024 Revised: February 25, 2025 Accepted: March 10, 2025 Published online: September 9, 2025 Processing time: 293 Days and 0.2 Hours
Abstract
The Sengstaken-Blakemore tube (SB tube), introduced in the 1950s, was a pivotal device for managing acute gastrointestinal (GI) bleeding, particularly from esophageal varices. This multi-lumen tube, featuring esophageal and gastric balloons, applied mechanical pressure to control bleeding and provided a temporary solution until more definitive treatments could be employed. It was historically significant in resource-limited settings where advanced endoscopic options were unavailable, enabling patient stabilization and transfer to specialized centers. However, the advent of GI endoscopy and its increased availability has rendered the SB tube obsolete. SB tubes are associated with complications, including esophageal perforation, aspiration pneumonia, and gastric ulceration. Additionally, the tube can cause significant discomfort, and its migration may lead to inadequate. Techniques such as endoscopic variceal ligation and endoscopic sclerotherapy offer superior precision, efficacy, and safety for managing variceal bleeding. Improved hospital transfer protocols now facilitate prompt endoscopic or surgical interventions, reducing the need for temporary measures like the SB tube. Additionally, advancements in pharmacological treatments, including vasoactive drugs, reliance on mechanical compression devices. While the SB tube remains an important historical artifact, its role in current medical practice reflecting safer and more effective treatment options in emergency GI care. This review discusses the declining role of the Sengstaken -Blakemore tube and its replacement by current intervention methods.
Core Tip: The Sengstaken-Blakemore tube, introduced in the 1950s, was once vital in managing acute gastrointestinal (GI) bleeding, particularly from esophageal varices. Over the years, modern techniques with advanced precision, efficacy, and safety for managing variceal bleeding have emerged, causing a significant decline in its use. Today, the interplay between the introduction of GI endoscopy and enhanced pharmacological interventions render the Sengstaken-Blakemore tube obsolete in emergency GI care. The decline of the historically significant device warrants a review its replacements.
