Balloon tamponade using Sengstaken-Blakemore (SB) tube is employed as a bridging
therapy in cases in which endoscopic
therapy fails to control esophageal variceal
bleeding. Although SB tube insertion can lead to successful hemostasis, it is accompanied by numerous complications, with SB tube transection being one of the rarest complications. A 53-year-old man with
liver cirrhosis and
hepatocellular carcinoma presented with massive esophageal variceal
bleeding. Therapeutic endoscopic variceal
ligation failed, and SB tube was inserted. The SB tube was unexpectedly disconnected because of the patient's irritability due to
hepatic encephalopathy. The esophageal and
gastric balloon of the SB tube remained inflated in the stomach. Whereas the use of other endoscopic instruments was ineffective, endoscopic removal was successfully accomplished using endoscopic scissors. In conclusion, we detected SB tube transection in a patient with
hepatic encephalopathy and removed remnants of the inflated tube using endoscopic scissors.