Pulmonary glue embolism and interstitial pneumonitis following endoscopic cyanoacrylate injection: A case report

Endoscopic injection of a cyanoacrylate-lipiodol mixture is widely regarded as the first-line treatment for gastrointestinal bleeding secondary to ruptured gastric varices. Although generally effective, this technique carries the risk of rare but potentially life-threatening complications, including pulmonary glue embolism and interstitial pneumonitis. We present the case of a 65-year-old woman with cirrhosis who presented with hematemesis and melena and underwent endoscopic cyanoacrylate-lipiodol injection for bleeding gastroesophageal varices. Within 24 hours, she developed a persistent fever and bilateral crackles. Chest X-ray, CT imaging, and bronchoscopy findings were consistent with glue-induced pneumonitis. Corticosteroid therapy resulted in rapid clinical and radiological improvement. This case highlights the importance of recognising pulmonary complications following cyanoacrylate injection for gastric varices and underscores the need for prompt diagnosis and appropriate management to mitigate morbidity.