Gastric varices in portal hypertension can cause life threatening hemorrhage which is difficult to control by conventional injection sclerotherapy. An 81 year old cirrhotic male with grade III-IV esophageal varices and concomitant type II gastric varices with hematocystic spot has been seen for the past year due to recurrent bleeding from the esophageal varices successfully obliterated by rubber band litigation. He had another episode of hematemesis and melena and repeat endoscopy showed active bleeding of the gastric varices. A total of 1.8 ml of N-butyl-2-cyanoacrylate (Histoacryl), a tissue adhesive polymer was injected in 2 sites. There were no post-injection complications noted and was discharged after 2 days. Endoscopic follow-up at one month revealed hardened, obliterated gastric varices.
This is the first report of histoacryl glue obliteration of gastric varices in the country. It is a safe, efficient nd elegant endoscopic technique for controlling gastrolling gastric variceal hemorrhage.