Hypertension artérielle pulmonaire aiguë réfractaire et fatale due à la migration de colle après le traitement d'une varice cardio-tubérositaire

We report the case of a 65-old-year cirrhotic woman admitted in ICU for gastrointestinal bleeding due to gastric varice rupture treated with glue (Glubran2®, GEM). Few hours after the endoscopic treatment, the patient developed acute right ventricle insufficiency. Swan Ganz catheter revealed hemodynamic failure associated with major pulmonary hypertension. Chest scanner showed multiple contrast-enhanced pulmonary emboli due to glue migration. The patient died from refractory right heart failure. Glue migration is a well-known complication. Nevertheless, glue migration resulting in major refractory pulmonary hypertension is unusual and anesthesiologist and/or intensivist teams should be aware of this complication. In this case, we discuss glue migration risk factors, radiological investigation approach, possible pulmonary hypertension mechanisms, and therapeutic options.