Endoscopic obturation using cyanoacrylate glue injection is currently the reference treatment for active gastrointestinal bleeding due to ruptured gastric varices, as well as for secondary prophylaxis.

The aim of this study was to describe the epidemiological profile and clinical outcomes of patients who underwent biological glue injection for gastric varices.

This was a single-center, retrospective, descriptive study conducted over 4 years and 10 months, from March 2020 to January 2025, within the endoscopy unit of our department.

All patients who underwent esophagogastroduodenoscopy (EGD) with biological glue injection were included.

During the study period, 27 patients underwent endoscopic glue therapy. The mean age was 48 years (range 23–68). The sex ratio was 1.25 (15 women and 12 men).

All patients had clinically significant portal hypertension and presented with hemorrhagic decompensation: melena in 12 patients (44.4%), isolated hematemesis in 5 patients (18.5%), and hematemesis associated with melena in 10 patients (37%).

Portal hypertension was of cirrhotic origin in 14 patients (51.8%), secondary to Budd–Chiari syndrome in 2 women (7.4%), to portal vein thrombosis in 5 patients (18.5%), and remained under investigation in 6 patients (22.2%).

Gastric varices were classified as GOV2 in 14 patients (51.8%), GOV1 in 7 patients (25.92%), and IGV1 in 6 patients (22.2%). Gastric varices were associated with esophageal varices in 21 patients (77.7%).

The mean number of glue injection sessions was 1.9 per patient (range 1–3). Minor immediate bleeding occurred in 3 patients and was rapidly controlled with additional glue injection. Immediate therapeutic efficacy was achieved in 100% of cases.

During follow-up, rebleeding occurred in only 3 patients (11.11%), all successfully managed with a second glue injection session. Subcardial ulcerations at the previous injection site were observed in 2 patients (7.4%) during follow-up.

Biological glue injection is an effective technique for the treatment of gastrointestinal bleeding due to ruptured gastric varices, as well as for secondary prophylaxis. The recurrence rate remains low, confirming the value of this approach in the management of gastric variceal bleeding.