Radiological features of pulmonary fat embolism in trauma patients: a case series

Dwivedi, Shourye; Kimmel, Lara A; Kirk, Andrea; Varma, Dinesh

doi:10.1007/s10140-021-01969-4

Cited by 4 publications

(4 citation statements)

References 32 publications

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“…22 This, to some extent, could explain the rarity of visualisation of macroscopic fat emboli within pulmonary vessels in the CTPA. 24 As in our study, there were only 31 patients out of 122 patients with computed tomographic angiograms available that presented with fat emboli in the pulmonary vessels.…”

Section: Discussionmentioning

confidence: 59%

Pulmonary CT imaging findings in fat embolism syndrome: case series and literature review

Zhou

et al. 2023

Clinical Medicine

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BackgroundFat embolism syndrome (FES) is a rare life-threatening complication, which commonly affects the lung. Currently, the most widely accepted criteria for the diagnosis of FES are the Gurd and Wilson Criteria established nearly 40 years ago, but without pulmonary images involved. Our study aims to analyse the pulmonary computed tomography (CT) findings seen in FES. Case presentationThis report enrolled four cases of FES with lung involvement. The mainly symptoms and signs included dyspnea, disturbance of consciousness, anemia, thrombocytopenia and, most notably, ground-glass opacities, septal thickening, ill-defined centrilobular nodules, and patchy consolidation were demonstrated on bilateral lungs. Combining the clinical manifestations and laboratory tests, the diagnosis of FES was confirmed. With the treatment of steroids, anti-coagulation and supportive treatment, the four patients' symptoms were relieved, abnormalities in chest CT were absorbed significantly and the patients were finally discharged. ConclusionsThere are several common manifestations of FES in pulmonary CT images, and the lung parenchymal features give more information for the diagnosis of FES than the pulmonary vessel findings. Given the absence of a gold standard diagnostic test for FES, further investigation to explore new diagnostic criteria of FES involving pulmonary radiological features is needed in the future.

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Section: Discussionmentioning

confidence: 59%

Pulmonary CT imaging findings in fat embolism syndrome: case series and literature review

Zhou

et al. 2023

Clinical Medicine

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“…A retrospective review of radiological features on CTPA images of 15 patients diagnosed clinically with pulmonary fat embolism reported pulmonary opacity in 14 (93.3%) patients, ground-glass opacities in 9 (64.3%), alveolar opacities in 6 (42.9%), interlobular septal thickening in 10 (66.7%), and pleural effusions in 7 (46.7%) ( 9 ). Pulmonary artery filling defects were observed on CTPA only in 3 (20%) patients, suggesting that pulmonary artery filling defects are not commonly seen in patients with pulmonary fat embolism ( 10 ). In our case, the chest image showed diffuse exudation and consolidation in both lungs—considered to be a manifestation of ARDS secondary to pulmonary fat embolism—that was absorbed completely in 2 weeks, which is consistent with a previous report ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…Pulmonary artery filling defects were observed on CTPA only in 3 (20%) patients, suggesting that pulmonary artery filling defects are not commonly seen in patients with pulmonary fat embolism ( 10 ). In our case, the chest image showed diffuse exudation and consolidation in both lungs—considered to be a manifestation of ARDS secondary to pulmonary fat embolism—that was absorbed completely in 2 weeks, which is consistent with a previous report ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

Rare case of pulmonary fat embolism and acute respiratory distress syndrome after liposuction and fat grafting: a case report

et al. 2023

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BackgroundPulmonary fat embolism usually occurs after fracture, yet rarely observed after liposuction and fat grafting.Case presentationWe describe a 19-year-old female patient who presented with acute respiratory failure and diffuse pulmonary opacities on chest radiographic image shortly after liposuction and fat grafting. Bronchoalveolar lavage was performed and lipid content in alveolar cells contribute to the diagnosis of the fat embolism syndrome. The patient was successfully treated with noninvasive mechanical ventilation and a short course of glucocorticoids.ConclusionsEarly recognition and appropriate treatment are very important to improve the outcome of pulmonary fat embolism. Considering that liposuction and fat grafting are increasingly common cosmetic surgeries, our aim is to raise awareness for this rare adverse event.

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“…Chest X-ray is grossly normal but can have florid presentation varying from bilateral lung infiltrates to a fullfledged pulmonary edema, diffused interstitial infiltrates and snow storm appearance (Figure 7). 18,19…”

Section: Imagingmentioning

confidence: 99%

Fat embolism syndrome: a case series and review of literature

et al. 2022

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Fat embolism and fat embolism syndrome (FES) is a clinical spectrum characterized by dissemination of fat emboli into the systematic circulation usually as a result of orthopedic trauma and related surgical procedures. we present a case series of three patients who had FES of variable presentation and severity. In our first case patient initially developed FES pre operatively which was complicated by acute pulmonary thromboembolism in the post operative period. In our third case patient developed FES after intra medullary nail fixation of femoral shaft fracture. Fat embolism is relatively rare but fatal complication in orthopedic trauma and during long bone fracture manipulations. In addition, fat embolism is a risk factor for pulmonary thromboembolism as was evident in our first case. So, patients of fat embolism should be closely monitored for the later. Gurd and Wilson are the most commonly used criteria for the diagnosis of FES. Treatment is largely supportive and some preventive measures include early fixation of long bone fractures. Prophylactic use of steroids in a meta-analysis has been found to prevent occurrence of FES in nearly two third of patients. There is no proven role of hypertonic dextrose infusion, heparin or corticosteroids in the treatment of FES and therefore are not routinely recommended. In case of fulminant FES steroids should be considered.

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Radiological features of pulmonary fat embolism in trauma patients: a case series

Cited by 4 publications

References 32 publications

Pulmonary CT imaging findings in fat embolism syndrome: case series and literature review

Pulmonary CT imaging findings in fat embolism syndrome: case series and literature review

Rare case of pulmonary fat embolism and acute respiratory distress syndrome after liposuction and fat grafting: a case report

Fat embolism syndrome: a case series and review of literature

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