Case Report: Esophageal balloon occlusion with a Foley catheter in high-risk sedated gastroscopy

Key Takeaways for GI Nurses

• Foley catheter balloon occlusion represents an innovative airway protection technique that may be considered for high-risk patients undergoing sedated upper endoscopy
• This intervention requires enhanced nursing vigilance and specialized monitoring protocols, particularly for patients with increased aspiration risk or compromised airway reflexes
• Implementation of esophageal balloon occlusion demands interdisciplinary coordination between nursing, anesthesia, and gastroenterology teams to ensure patient safety
• Understanding alternative airway management strategies expands the toolkit available for managing complex endoscopic cases in challenging patient populations

Clinical Relevance

This case report introduces endoscopy nurses to a specialized technique that addresses one of our most significant patient safety concerns: aspiration prevention during sedated upper endoscopy. For high-risk patients—including those with altered mental status, compromised gag reflexes, or increased gastric contents—traditional airway protection methods may prove inadequate. The use of esophageal balloon occlusion with a Foley catheter represents a creative adaptation of readily available equipment to enhance patient safety in these challenging scenarios.

From a nursing practice perspective, this technique requires significant modifications to standard procedural protocols. Nurses must be prepared to assist with balloon placement and inflation, monitor for appropriate positioning, and recognize potential complications such as esophageal trauma or inadequate occlusion. This intervention also necessitates enhanced pre-procedural assessment skills to identify appropriate candidates and post-procedural monitoring to ensure safe balloon removal and assess for any related complications.

The implementation of such specialized techniques also highlights the evolving role of endoscopy nurses as critical members of the procedural team. As endoscopic procedures become increasingly complex and patient populations more challenging, nurses must stay current with innovative approaches while maintaining expertise in fundamental safety principles. This case underscores the importance of continuing education, interdisciplinary communication, and the development of unit-specific protocols for managing high-risk scenarios.

Bottom Line

While esophageal balloon occlusion with a Foley catheter may offer enhanced airway protection for select high-risk patients during sedated gastroscopy, its implementation requires careful patient selection, specialized training, and robust safety protocols—making this an advanced technique that endoscopy nurses should understand conceptually while recognizing it may only be appropriate in specialized centers with experienced teams and comprehensive support systems.