Gastric varices are enlarged veins found in the stomach. They mainly occur in patients with portal hypertension. While gastric varices bleed less frequently than esophageal varices, the severity of bleeding and associated mortality is greater. Cyanoacrylate glue is a liquid substance with the consistency of water that transforms into a solid state when added to a physiological medium such as blood. When instilled into a varix using the standard method of intravariceal injection, the glue undergoes an instantaneous polymerization reaction and hardens to a rock hard substance, thereby plugging the lumen of the varix. This enables rapid hemostasis of active bleeding and prevents rebleeding.
A therapeutic gastroscope with a large working channel is used for injection. Variceal injection is performed with a 23-gauge disposable sclerotherapy needle. The varix is punctured under direct visualization and approximately 1cc of the glue is injected intravariceally. After injection, the patency of the varix is assessed with blunt catheter palpation and additional glue injected until the varices are obliterated.
Cyanoacrylate compounds are routinely used in different medical and surgical subspecialties for embolization of aneurysms, arteriovenous malformations and fistulae, and as a wound or tissue adhesive. The safety profile of cyanoacrylate glue for varix obliteration is excellent. A minority of patients develop transient fever and pain after injection. There have been rare case reports of complications related to embolization, which include cerebral stroke and pulmonary embolism. Visceral fistulas have also been reported, probably due to misguided injections.
Frequently Asked Questions
'
Endoscopic Glue Injection is a minimally invasive procedure used to stop or prevent bleeding from enlarged veins (gastric varices) in the stomach by injecting a special medical adhesive directly into the affected blood vessels.
The procedure is performed to control active bleeding or reduce the risk of future bleeding from gastric varices, which commonly develop due to portal hypertension associated with liver disease.
Your doctor may recommend Endoscopic Glue Injection if you have bleeding gastric varices, enlarged stomach veins caused by portal hypertension, or are at high risk of variceal bleeding.
During the procedure, an endoscope is passed through the mouth into the stomach. A special medical glue is injected directly into the bleeding or enlarged vein to seal it and stop the bleeding.
No. The procedure is usually performed under sedation, allowing patients to remain comfortable throughout the treatment. Mild throat discomfort or bloating may occur temporarily after the procedure.
The procedure generally takes 30 to 60 minutes, depending on the severity of the condition and whether additional endoscopic treatment is required.
Endoscopic Glue Injection provides rapid control of bleeding, reduces the risk of recurrent bleeding, avoids major surgery in many cases, and promotes quicker recovery through a minimally invasive approach.
Endoscopic Glue Injection is generally safe when performed by an experienced gastroenterologist. Although uncommon, potential risks include bleeding, infection, ulcer formation, glue embolization, or recurrence of variceal bleeding.
Yes. Your doctor may recommend follow-up endoscopy to assess the treated varices, monitor healing, and determine if additional treatment sessions are required.
After the procedure, you will be monitored until the effects of sedation wear off. Your doctor will explain the findings, provide dietary and medication advice, and schedule follow-up visits if necessary to ensure successful treatment.
