Glue injection of Gastric Varix

Gastric varices are dilated submucosal veins in the lining of the stomach, which can be a life-threatening cause of bleeding in the upper gastrointestinal tract. Commonly found in patient of cirrhosis with portal hypertension. Also found in patients with thrombosis of the splenic vein. Gastric varices are encountered less frequently than esophageal varices. Nonetheless, gastric variceal bleeding is more severe and associated with worse outcomes. 

Patients gastric varices can present with bloody vomiting (hematemesis), black tarry stools (melena), or rectal bleeding. The bleeding may be brisk and severe enough to develop shock.

Cyanoacrylate glue injection is currently recommended as first-line treatment for bleeding gastric varix. This procedure carries a risk of embolization, as the glue can flow through the bloodstream before it solidifies. Though the risk of embolization is low, but it has occurred and can result in serious morbidity and mortality.

Other techniques for refractory bleeding include

• - Transjugular intrahepatic portosystemic shunts (TIPS)
• - Balloon occluded retrograde transvenous obliteration techniques (BORTO)
• - Coil-Assisted Retrograde Transvenous Obliteration (CARTO)
• - Intra-gastric balloon tamponade as a bridge to further therapy

Cyanoacrylate glue injection is currently recommended as first-line treatment for bleeding gastric varix. However, this procedure carries a risk of embolization, as the glue can flow through the bloodstream before it solidifies. The risk of embolization is low, but it has occurred and can result in serious morbidity and mortality.

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