Pulmonary Embolization of 2-Octyl Cyanoacrylate After Endoscopic Injection Therapy for Gastric Variceal Bleeding Otis B. Rickman, DO, James P. Utz, MD,

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Pulmonary Embolization of 2-Octyl Cyanoacrylate After Endoscopic Injection Therapy for Gastric Variceal Bleeding Otis B. Rickman, DO, James P. Utz, MD, Gregory L. Aughenbaugh, MD, Christopher J. Gostout, MD Mayo Clinic Proceedings Volume 79, Issue 11, Pages 1455-1458 (November 2004) DOI: 10.4065/79.11.1455 Copyright © 2004 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 1 Initial computed tomographic pulmonary angiogram of the chest. Left, Embolized glue material is not visible at window settings used routinely for computed tomographic pulmonary angiography. Right, Embolized glue in the pulmonary artery branches (arrow) is visible at window settings appropriate for evaluating bone or other high-attenuation material. Mayo Clinic Proceedings 2004 79, 1455-1458DOI: (10.4065/79.11.1455) Copyright © 2004 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 2 Computed tomographic venogram. Left, Low-attenuation infarction (arrows) is seen in an enlarged spleen, along with ascites and pleural effusions; no inferior vena cava thrombus is seen. Right, High-attenuation or opaque material (arrow) consistent with embolized cyanoacrylate is seen in branches of the pulmonary arteries of the right lower lobe of the lung. Mayo Clinic Proceedings 2004 79, 1455-1458DOI: (10.4065/79.11.1455) Copyright © 2004 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 3 Unenhanced computed tomogram obtained 6 months after patient was discharged shows that a small amount of residual embolized opaque material (arrow) remains in the right lower lobe of the lung. Mayo Clinic Proceedings 2004 79, 1455-1458DOI: (10.4065/79.11.1455) Copyright © 2004 Mayo Foundation for Medical Education and Research Terms and Conditions