1. Pulmonary embolism: a complication of endoscopic variceal treatment.
- Author
-
Diaz Garcia G, Boppana LKT, Izzo C, Ashby T, and Louis M
- Subjects
- Humans, Male, Middle Aged, Tomography, X-Ray Computed, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage therapy, Liver Cirrhosis complications, Pulmonary Embolism etiology, Pulmonary Embolism diagnostic imaging, Esophageal and Gastric Varices therapy, Cyanoacrylates adverse effects, Cyanoacrylates administration & dosage
- Abstract
Gastric varices (GVs) are dilated veins in the stomach submucosa, typically caused by portal hypertension. A prompt diagnosis is needed, given the significant risk of bleeding and mortality. Endoscopic cyanoacrylate injections are widely adopted for treating GV due to their efficacy in preventing rebleeding with lower complication rates. Although rare, cyanoacrylate injections can lead to pulmonary embolism (PE) via the migration of glue through portosystemic shunts or other vascular pathways into the pulmonary circulation. Diagnosing cyanoacrylate glue pulmonary emboli can be challenging due to its radiopaque nature on imaging. We present a case of a male patient in his 50s, with liver cirrhosis who developed a PE following an endoscopic cyanoacrylate injection for an isolated gastric varix. The patient presented with pleuritic chest pain and haemoptysis, and CT chest revealed evidence of glue embolisation material within both lungs. Treatment with supportive care and close monitoring improved and resolved symptoms., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2025. No commercial re-use. See rights and permissions. Published by BMJ Group.)
- Published
- 2025
- Full Text
- View/download PDF