Hemostasis Using Esophageal Balloon of Sengstaken-Blakemore Tube for Ulcer Bleeding at Esophagogastric Anastomosis: A Case Report.

Background and Clinical Significance: Sengstaken-Blakemore tube insertion is a temporary but important intervention for uncontrolled upper gastrointestinal bleeding, especially when endoscopic hemostasis fails. Case presentation: We present the case of a 63-year-old man with a history of esophageal cancer surgery and gastric variceal treatment who presented to the emergency department with hematemesis and altered consciousness. Endoscopy revealed a bleeding ulcer at the intrathoracic esophagus. Endoscopic band ligation failed, and the patient's condition deteriorated, prompting the insertion of an Sengstaken-Blakemore tube. Owing to prior Ivor Lewis surgery, the gastric balloon was not used; only the esophageal balloon was inflated, and hemostasis was successfully achieved. Despite the relative contraindication of prior esophageal surgery, no complications occurred. The patient was discharged on hospital day 20 without recurrence. Conclusions: This case illustrates that in patients with unstable upper gastrointestinal bleeding with surgical history, selective use of Sengstaken-Blakemore tube may offer life-saving hemostasis when endoscopy fails, even when standard indications are not met.