Whatever Became of the Esophageal Balloon Tube?-Reply

To the Editor.–Since its introduction by Sengstaken and Blakemore in 1950, esophageal balloon tamponade has been used throughout the world to control bleeding from esophageal varices. Abundant data indicate that balloon tamponade stops bleeding temporarily in 45% to 84% of patients. The disheartening feature of this form of treatment is that a majority of patients (80% in a two-year prospective study that we conducted) resume bleeding when the balloons are deflated. Moreover, in the experience of many workers, balloon tamponade is associated with an inordinate incidence of complications, including aspiration pneumonia, perforation of the esophagus, and asphyxia from slippage of the balloon up into the pharynx. Most important, a large amount of data have shown that balloon tamponade has failed to lower the mortality from bleeding varices in cirrhosis despite 24 years of wide-spread trial.

We have found that systemic intravenous injection of posterior pituitary extract (Pituitrin) (20 units