Cortical blindness and acute myocardial infarction following injection of bleeding gastric varices with cyanoacrylate glue.

A 65−year−old man, who had been diag− nosed 20 years previously with noncir− rhotic portal hypertension due to bilhar− ziasis, was admitted with gastric variceal bleeding. He had undergone esophageal variceal eradication in the past. The vari− ces were injected with cyanoacrylate di− luted with Lipiodol (1.5 ml/2.1ml). After several hours, the patient complained of chest pain and an inability to see. Investi− gation revealed inferior wall myocardial infarction and cortical blindness. Noncon− trast computed tomography of the brain showed multiple hyperdense foci sugges− tive of cyanoacrylate emboli in the cere− bral arteries, and bilateral occipital in− farcts (Figure 1).