{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:13:23Z","timestamp":1788786803798,"version":"build-2803163510"},"reference-count":10,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,12,11]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1136\/bcr-2024-263011","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T23:45:44Z","timestamp":1737503144000},"page":"e263011","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Pulmonary embolism: a complication of endoscopic variceal treatment"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-3952-2208","authenticated-orcid":false,"given":"Gerardo","family":"Diaz Garcia","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5165-2768","authenticated-orcid":false,"given":"Leela Krishna Teja","family":"Boppana","sequence":"additional","affiliation":[{"name":"Pulmonary and Critical Care, University of Florida College of Medicine, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Izzo","sequence":"additional","affiliation":[{"name":"Pulmonary and Critical Care, University of Florida College of Medicine, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6452-5928","authenticated-orcid":false,"given":"Tracy","family":"Ashby","sequence":"additional","affiliation":[{"name":"Pulmonary and Critical Care, University of Florida College of Medicine, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0083-2045","authenticated-orcid":false,"given":"Mariam","family":"Louis","sequence":"additional","affiliation":[{"name":"Pulmonary and Critical Care, University of Florida College of Medicine, Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"2025082711585545000_18.1.e263011.1","unstructured":"Meseeha M , Attia M . Esophageal Varices. Treasure Island (FL): StatPearls Publishing, 2024. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK448078\/#:~:text=It%20is%20mor e%20common%20in"},{"key":"2025082711585545000_18.1.e263011.2","doi-asserted-by":"crossref","DOI":"10.3390\/medicina55070335","article-title":"Current Approaches to the Treatment of Gastric Varices: Glue, Coil Application, TIPS, and BRTO","volume":"55","author":"Goral","year":"2019","journal-title":"Medicina (Kaunas)"},{"key":"2025082711585545000_18.1.e263011.3","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.4103\/1735-1995.172990","article-title":"Gastric varices: Classification, endoscopic and ultrasonographic management","volume":"20","author":"Wani","year":"2015","journal-title":"J Res Med Sci"},{"key":"2025082711585545000_18.1.e263011.4","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.01.058"},{"key":"2025082711585545000_18.1.e263011.5","first-page":"123","article-title":"Endoscopic Ultrasound-Guided Coil and Glue Injection for Gastric Variceal Bleeding","volume":"14","author":"Binmoeller","year":"2018","journal-title":"PM"},{"key":"2025082711585545000_18.1.e263011.6","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S0973-6883(12)60088-7","article-title":"Gluing gastric varices in 2012: lessons learnt over 25 years","volume":"2","author":"Saraswat","year":"2012","journal-title":"J Clin Exp Hepatol"},{"key":"2025082711585545000_18.1.e263011.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.01.027"},{"key":"2025082711585545000_18.1.e263011.8","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.vgie.2020.11.021","article-title":"Use of cyanoacrylate glue in gastric variceal bleed: a modified technique without using lipiodol","volume":"6","author":"Desai","year":"2021","journal-title":"VideoGIE"},{"key":"2025082711585545000_18.1.e263011.9","doi-asserted-by":"crossref","first-page":"249","DOI":"10.4103\/sja.sja_673_22","article-title":"Pulmonary biological glue embolism after endoscopic repair of gastric varices - A case report","volume":"17","author":"Penedos","year":"2023","journal-title":"Saudi J Anaesth"},{"key":"2025082711585545000_18.1.e263011.10","unstructured":"Khan MA , Anis A , Nayyer A , et al . Glue embolization to the lung vasculature following histoacryl injection."}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263011","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:59:06Z","timestamp":1756321146000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263011"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,21]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bcr-2024-263011"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263011","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}