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Background and Clinical Significance: Sengstaken–Blakemore tube insertion is a temporary but important intervention for uncontrolled upper gastrointestinal bleeding, especially when endoscopic hemostasis fails. Case presentation: We present the case of a 63-year-old man with a history of esophageal cancer surgery and gastric variceal treatment who presented to the emergency department with hematemesis and altered consciousness. Endoscopy revealed a bleeding ulcer at the intrathoracic esophagus. Endoscopic band ligation failed, and the patient’s condition deteriorated, prompting the insertion of an Sengstaken–Blakemore tube. Owing to prior Ivor Lewis surgery, the gastric balloon was not used; only the esophageal balloon was inflated, and hemostasis was successfully achieved. Despite the relative contraindication of prior esophageal surgery, no complications occurred. The patient was discharged on hospital day 20 without recurrence. Conclusions: This case illustrates that in patients with unstable upper gastrointestinal bleeding with surgical history, selective use of Sengstaken–Blakemore tube may offer life-saving hemostasis when endoscopy fails, even when standard indications are not met. Full article

Efficient nutritional support plays a pivotal role in the rehabilitation of sea turtles, ensuring a positive, swift, and successful recovery from clinical conditions for their reintroduction into the wild. For sea turtles in severely emaciated and underweight condition, the primary objective is to facilitate weight gain in terms of both muscle mass and fat reserves. Traditionally, many sea turtle rehabilitators have employed the practice of force-feeding, which also involves the daily insertion of an orogastric tube from the mouth to the stomach. However, this technique may be highly stressful for the animals, carrying the risks of regurgitation and potential harm, requiring the removal of the animal from the water, and subjecting it to uncomfortable and potentially dangerous handling. The procedure may also involve risks for operators. In this study, we explore the utilization of a permanent esophago-gastric tube (EG tube) in sea turtles as an alternative to force-feeding, providing a respectful and appropriate approach to meeting the nutritional needs of patients. The administration of food, essential medications, and fluids is performed directly with the turtle in its tank, minimizing the stress associated with handling, while ensuring the safety of operators. The study involves 195 marine turtles that underwent surgery for the placement of a permanent EG tube between 2008 and 2022. Of these, 116 animals were treated at the Sea Turtle Clinic of the Department of Veterinary Medicine at the University of Bari, South Adriatic Sea, Puglia (IT), and 79 patients were admitted to the Sea Turtle Rescue Center of Lampedusa, Central Mediterranean Sea, Sicily (IT). The loggerhead turtles (Caretta caretta) required EG tube placement due to their poor condition related to various diseases, which were systematically categorized. The duration of EG tube placement was analyzed regarding the specific condition of the animals and the nature of their injuries, considering any complications or differences between the two facilities. The results of the study will provide valuable information for the ongoing care and treatment of marine turtles in rehabilitation facilities. Full article

The coronavirus disease 2019 (COVID-19) pandemic has had a substantial impact on the provision of medical healthcare. Due to an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) transmission, elective surgical treatment has been suspended in many centers. The effects of COVID-19 in the early post-operative period after esophagectomy remains unknown. In this report, we present three cases of patients diagnosed with esophago-gastric junction cancer who were scheduled for elective esophagectomy with a curative intention during second wave of COVID-19 pandemic in a single high-volume tertiary center. Despite all available safety measures, one of the patients developed COVID-19 pneumonia on post-operative day two, leading to an impaired respiratory function and increased pleural fluid collection from the chest tube, resulting in a prolonged time of hospital stay. Finding a good balance between the COVID-19-related perioperative risks and consequences of delaying surgical treatment in patients diagnosed with esophago-gastric cancer is a challenge. In order to achieve the best possible outcome, care must be taken to ensure availability of necessary treatment options and to reduce the risk of SARS-Cov-2 transmission perioperatively. Full article