Imaging and histological findings of fat embolism in the vena cava

Vasconcelos, Vladimir; Andriotti, Carolina; Reicher, M. E.; Amorim, Jorge Eduardo de; Miranda, Fausto

doi:10.1177/1460408615589430

Cited by 3 publications

(6 citation statements)

References 18 publications

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“…Roson et al [6] reported a fat embolus in the right femoral vein increasing in size on serial imaging, prompting IVC filter placement and surgical thrombectomy. Vasconcelos et al [7] reported a large fat embolus in the left femoral vein and IVC, necessitating IVC filter placement and surgical thrombectomy.…”

Section: Discussionmentioning

confidence: 99%

“…It is rare, however, to encounter venous fat at the site of trauma on imaging. In our literature search we encountered only ten case reports of fat emboli in the venous system detected on computed tomography (CT) imaging to date, including one in the inferior vena cava (IVC) ( Table 1 ) [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] . Note that symptoms and signs and even imaging findings of fat emboli are often difficult to distinguish from those of concurrent trauma.…”

Section: Introductionmentioning

confidence: 99%

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Fat embolism in the popliteal vein detected on CT: Case report and review of the literature

Burr

Chaudhry

Zhang

et al. 2020

Radiology Case Reports

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Fat emboli are a common phenomenon, but are rarely detected or reported on extremity CT imaging. We present a case of fat embolus in the popliteal vein in the setting of a femoral fracture. This is the most distal fat embolus described in the literature. There are no guidelines regarding intervention if a fat embolus is detected in a peripheral vein on CT. A review of all the previous cases of peripheral fat emboli is presented for reference.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fat embolism in the popliteal vein detected on CT: Case report and review of the literature

Burr

Chaudhry

Zhang

et al. 2020

Radiology Case Reports

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“…The detection of macroscopic fat emboli in the systemic veins or pulmonary arteries through computed tomography (CT) is even rarer with only a few cases published, [2][3][4][5][6][7][8] to the authors' knowledge.…”

mentioning

confidence: 99%

“…2,3,6,8 The detection of fat emboli in the cerebral arterial circulation has also been reported as the 'hypodense artery sign'.…”

mentioning

confidence: 99%

“…Although there are reports of surgical intervention with venotomy for removal of the fat embolus and temporary placement of inferior vena cava filters, 6,8 its value is questionable. In autopsy studies endoluminal fat can be seen on lung vessels in more than 90% of patients with skeletal trauma; however, the clinical picture of fat embolism syndrome does not occur in all patients in whom intravascular fat is demonstrated.…”

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confidence: 99%

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Trauma Patient with Fat Embolism Detected on Computed Tomography

et al. 2017

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RESUMOA embolia gorda é frequente no contexto de fracturas de ossos longos, contudo o desenvolvimento da síndrome clínica da embolia gorda (caracterizada por dificuldade respiratória progressiva, depressão do estado de consciência e rash petequial) constitui uma ocorrência rara, embora relevante pela sua gravidade. Apresentamos o caso de um politraumatizado com fraturas múltiplas do membro inferior direito a quem foi detetada, em tomografia computorizada de urgência, a presença de êmbolos de gordura no lúmen da veia femoral comum homolateral. A visualização de êmbolos macroscópicos de gordura através de métodos de imagem deverá alertar o clínico para a possibilidade de desenvolvimento da síndrome da embolia gorda. Palavras-chave: Embolia Gordurosa/diagnóstico por imagem; Fracturas Ósseas; Tomografia Computadorizada ABSTRACTFat embolism is frequent following fractures of long bones, however the development of the clinical syndrome of fat embolism (characterized by progressive respiratory distress, mental status depression and petechial rash) is rare, but relevant because of its potential severity. We report a case of a trauma patient with multiple fractures of the right lower limb in whom an emergency computed tomography scan showed fat emboli within the lumen of the homolateral common femoral vein. The imaging detection of macroscopic fat emboli should alert the clinician to the potential for subsequent fat embolism syndrome.

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Cerebral fat embolism syndrome (FES): similar cases with different outcomes

Jorgensen¹,

Bashir

Satpathy

2018

BMJ Case Reports

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Fat embolism syndrome (FES) is a rare multisystem, clinical syndrome occurring in 0.9%–2.2% of long-bone fractures. The severity of FES can vary from subclinical with mild respiratory changes and haematological aberrations to a fulminant state characterised by sudden onset of severe respiratory and neurological impairment. Here we present two patients with cerebral FES secondary to femur fracture. Both patients exhibited profound neurological impairment with varied outcomes. Our cases highlight the importance of a high clinical suspicion of FES in patients with long-bone fractures and neurological deterioration. We recommend early plate osteosynthesis to prevent additional emboli in patients with FES and situational placement of intracranial pressure monitoring. Finally, cerebral FES has low mortality even in a patient with tentorial herniation and fixed, dilated pupils.

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Imaging and histological findings of fat embolism in the vena cava

Cited by 3 publications

References 18 publications

Fat embolism in the popliteal vein detected on CT: Case report and review of the literature

Fat embolism in the popliteal vein detected on CT: Case report and review of the literature

Trauma Patient with Fat Embolism Detected on Computed Tomography

Cerebral fat embolism syndrome (FES): similar cases with different outcomes

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