Endoscopic placement of Sengstaken-Blakemore tube

A Sengstaken-Blakemore (SB) tube, when used approximately, still has a place in the management of acute variceal bleeding. Due to a number of reported complications from the misplacement of this tube, an x-ray localization before full inflation of the gastric balloon is recommended as the standard of care. Here, we report a new technique of SB tube placement with endoscopic confirmation in three patients. This technique is easy, accurate, and can be performed in any unit where a patient with variceal bleeding can be managed. Because it cuts down on the need for an x-ray or ultrasound confirmation, this technique may well become the "standard of care" among the practicing gastroenterologists.