A complication of prolonged intestinal intubation: Gaseous distention of the terminal balloon

Abstract

A patient with regional enteritis was treated with a Cantor tube for relief of intestinal obstruction. Gaseous distention of the terminal balloon of the tube occurred necessitating removal by laparotomy and enterostomy. This rare complication is reviewed and discussed with special reference to etiology and prevention. The relationship of this complication to prolonged intubation is emphasized.

Hyperbaric therapy for the removal of an obstructing intestinal tube balloon

“…Frequent abdominal x-rays during prolonged intestinal intubation are recommended to evaluate development of balloon distention [3,4,7]. measured.…”

“…Since Cantor first described the phenomenon of balloon distention of the terminal portion of intestinal tubes in 1949, at least 19 cases of small bowel obstruction caused by balloon distention have been reported in the literature [1][2][3][4][5][6][7][8][9][10][11][12][13]. In the past, surgical laparotomy and enterostomy have been the methods of choice for the removal of the impacted balloon [1,7,8,11,13]. Noninvasive forms of treatment, such as gentle traction and proximal bowel decompression with a second tube, have been advocated; however, their success has been limited [2,6].…”

Complications of Gastrointestinal Intubation

“…The use of long intestinal-decompression tubes in adult patients has caused a variety of iatrogenic problems (3,4,(22)(23)(24)33,34,75,76). A relatively common finding is telescoping (accordion effect) of the small bowel upon the intraluminal indwelling tube (77) (Fig.…”

“…In single-lumen tubes devised by Cantor, Harris, Kaslow, and others, however, the inflated balloon becomes impacted and cannot be withdrawn nor will it pass. This complication tends to occur when the tube has been in place for a week or longer (24). It may require either surgical removal or percutaneous transabdominal-needle-puncture of the balloon under fluoroscopy (81,82).…”

“…Another potential complication of indwelling intestinal-decompression tubes is gaseous distention of the mercury bag (3,(22)(23)(24). The thinwalled latex balloon is highly permeable to carbon dioxide and hydrogen sulfide present within G. G. Ghahremani the distended intestinal loops.…”