Hazardous Gaseous Distention of Intestinal Balloons

Hyperbaric therapy for the removal of an obstructing intestinal tube balloon

“…Diffusion of gases through the walls of the rubber bag, which acts as a semipermeable membrane, is thought to take place [6,10,12,15]. The level of intramural pressure driving gas into the balloon as well as the solubility and diffusibility of the gas in rubber, the surface area of the balloon wall, and the duration of exposure of the balloon to gas are all significant factors affecting distention [6,12]. Thicker, less permeable neoprene rubber is used in some tubes to help decrease the inward diffusion of intestinal gas.…”

“…The analysis, however, was performed after the balloon was left exposed to air for 6 days [10]. Chromatographic analysis of balloon gas by Fricke showed the gas to be atmospheric air [6]. Intraluminal bowel gas in mechanical obstruction has been shown to be composed of 70% nitrogen, 6-12% carbon dioxide, and 10-12% oxygen [16,17].…”

“…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].…”

“…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]. Traction has resulted in forceful rupture of the balloon and spilling of its mercury contents [8].…”

Complications of Gastrointestinal Intubation

“…It may require either surgical removal or percutaneous transabdominal-needle-puncture of the balloon under fluoroscopy (81,82). To prevent this complication several authors have recommended that the mercury bag be vented by introducing 21-or 22-gauge needle holes in its wall prior to intestinal intubation (82,83).…”