Endoscopic Variceal Therapy With Multisystemic Glue Embolism: A Case Report and Narrative Review of a Rare but Severe Complication.

Gastroesophageal variceal bleeding is a life-threatening complication of portal hypertension in patients with cirrhosis. Endoscopic cyanoacrylate injection is an established therapy for variceal hemorrhage, but it may lead to rare systemic complications, including glue embolization. The authors report the case of a patient with decompensated cirrhosis who developed acute gastroesophageal variceal bleeding, managed with endoscopic variceal ligation and cyanoacrylate injection. Postprocedural investigations revealed multiple emboli involving the cerebral, pulmonary, coronary, and renal vascular territories. The present case report and review of the literature highlight the need for increased awareness of glue embolization as a potential adverse effect of cyanoacrylate therapy. Careful patient selection, refined endoscopic technique, and close postprocedure monitoring are essential to minimizing the risks of embolization, reducing complications and optimizing outcomes.