Which of the following tubes is used to manage upper gastrointestinal hemorrhage due to esophageal varices?

JODHPUR AIIMS SNO-2018

Medical Surgical Nursing

Easy

Appeared in: JODHPUR AIIMS SNO-2018

Explanation

The Sengstaken-Blakemore tube is specifically designed to control bleeding from esophageal varices through tamponade.
As seen in the image, it features two inflatable balloons (gastric and esophageal) that apply direct pressure to the source of bleeding.
The gastric balloon anchors the tube in the stomach, while the long esophageal balloon compresses the varices in the esophagus.
It is used as a temporary, life-saving measure in cases of massive upper GI hemorrhage when endoscopic methods fail or are unavailable.

Option A: A Jackson-Pratt (JP) drain is a closed-suction device used for postoperative drainage to prevent fluid accumulation (seroma or hematoma) at a surgical site.
Option C: A T tube is placed in the common bile duct after gallbladder or bile duct surgery to ensure bile drainage while the duct heals.
Option D: A Penrose drain is a soft, open drain that uses gravity to remove fluids from a wound area onto a dressing. It is a passive drain.

Clinical Relevance

Nursing practice connection: Knowing Management of Gastrointestinal Hemorrhage helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must have scissors readily available at the bedside of a patient with a Sengstaken-Blakemore tube. If the patient develops respiratory distress, the nurse must immediately cut the tube lumens to deflate the balloons and relieve airway compression.
The esophageal balloon should be deflated periodically (e.g., for 10 minutes every 3 hours, per protocol) to prevent mucosal necrosis from prolonged pressure.
What if the bleeding was from a gastric ulcer instead of varices? In that case, a Sengstaken-Blakemore tube would be ineffective and contraindicated. Treatment would involve IV fluids, proton pump inhibitors, and endoscopic therapy like clipping or cauterization of the bleeding vessel.

How to Approach the Question

First, analyze the question to identify the core clinical problem: managing bleeding from esophageal varices.
Next, examine the image provided. Identify the device shown, noting its key features like multiple lumens and inflatable balloons.
Correlate the identified device with its known clinical application. Recognize that the Sengstaken-Blakemore tube is specifically used for esophageal tamponade.
Evaluate the given options. Compare the function of each tube/drain with the requirement of the question.
Eliminate the distractors: Jackson-Pratt, T tube, and Penrose drain are used for general surgical drainage, not for controlling internal hemorrhage via tamponade.
Select the option that matches both the visual information and the clinical scenario.

Concept Tested & Keywords

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