open access

Ahead of Print
CASE REPORT
Published online: 2020-01-13
Get Citation

Fat embolism syndrome case in woman presenting with a multiple injury following a traffic accident successfully treated using interdisciplinary approach - case report

Szymon Białka, Adam Ubych, Jacek Smereka, Tomasz Byrczek, Krzysztof Szaniewski, Lukasz Szarpak
DOI: 10.5603/DEMJ.a2020.0004

open access

Ahead of Print
CASE REPORT
Published online: 2020-01-13

Abstract

Background: A potential complication of extensive injuries is an episode of fat embolism, also referred to as fat embolism syndrome. The main causes of fat embolism include long bone and pelvic fractures. Symptoms of fat embolism may also develop after elective orthopedic surgery, removal of subcutaneous fat tissue, multiple rib fractures, acute pancreatitis, or parenteral nutrition with fat-containing products.Most of the possible clinical signs are non-specific. The triad of clinical signs including gas exchange disorders in the lungs, central nervous system disorders, and bloody petechiae on the skin makes fat embolism syndrome diagnosis much easier. However, the final diagnosis is based on meeting one large criterion, four small criteria, and one laboratory criterion in accordance with Gurd’s assumptions. Methods: Manuscript description a case of 44-year-old woman with a multiple injury following a traffic accident. Computed tomography revealed a extensive head injury, numerous fractures of ribs, transverse processes of thoracic vertebrae and right scapula. As a result of the injuries developed full-blown fat embolism syndrome. Conclusions: This case highlights the importance of appropriate knowledge of the pathomechanism and clinical presentation of fat embolism syndrome and interdisciplinary therapeutic team approach. A quick correct diagnosis is crucial to improve treatment results. Access to laboratory and imaging tests considerably facilitates the diagnostic process, which should be followed by optimal therapeutic management. The lack of a golden standard of treatment necessitates a flexible and interdisciplinary therapeutic approach.

Abstract

Background: A potential complication of extensive injuries is an episode of fat embolism, also referred to as fat embolism syndrome. The main causes of fat embolism include long bone and pelvic fractures. Symptoms of fat embolism may also develop after elective orthopedic surgery, removal of subcutaneous fat tissue, multiple rib fractures, acute pancreatitis, or parenteral nutrition with fat-containing products.Most of the possible clinical signs are non-specific. The triad of clinical signs including gas exchange disorders in the lungs, central nervous system disorders, and bloody petechiae on the skin makes fat embolism syndrome diagnosis much easier. However, the final diagnosis is based on meeting one large criterion, four small criteria, and one laboratory criterion in accordance with Gurd’s assumptions. Methods: Manuscript description a case of 44-year-old woman with a multiple injury following a traffic accident. Computed tomography revealed a extensive head injury, numerous fractures of ribs, transverse processes of thoracic vertebrae and right scapula. As a result of the injuries developed full-blown fat embolism syndrome. Conclusions: This case highlights the importance of appropriate knowledge of the pathomechanism and clinical presentation of fat embolism syndrome and interdisciplinary therapeutic team approach. A quick correct diagnosis is crucial to improve treatment results. Access to laboratory and imaging tests considerably facilitates the diagnostic process, which should be followed by optimal therapeutic management. The lack of a golden standard of treatment necessitates a flexible and interdisciplinary therapeutic approach.

Get Citation

Keywords

fat embolism syndrome; multiple injury; interdisciplinary therapeutic approach; case report

About this article
Title

Fat embolism syndrome case in woman presenting with a multiple injury following a traffic accident successfully treated using interdisciplinary approach - case report

Journal

Disaster and Emergency Medicine Journal

Issue

Ahead of Print

Published online

2020-01-13

DOI

10.5603/DEMJ.a2020.0004

Keywords

fat embolism syndrome
multiple injury
interdisciplinary therapeutic approach
case report

Authors

Szymon Białka
Adam Ubych
Jacek Smereka
Tomasz Byrczek
Krzysztof Szaniewski
Lukasz Szarpak

References (9)
  1. Stein PD, Yaekoub AY, Matta F, et al. Fat embolism syndrome. Am J Med Sci. 2008; 336(6): 472–477.
  2. Berlot G, Bussani R, Shafiei V, et al. Fulminant Cerebral Fat Embolism: Case Description and Review of the Literature. Case Rep Crit Care. 2018; 2018: 7813175.
  3. Newbigin K, Souza CA, Torres C, et al. Fat embolism syndrome: State-of-the-art review focused on pulmonary imaging findings. Respir Med. 2016; 113: 93–100.
  4. Zhibin Z, Peng S, Fang C. Fat embolism following a liposuction procedure. Neurol India. 2018; 66(4): 1206–1207.
  5. Akhtar S. Fat embolism. Anesthesiol Clin. 2009; 27(3): 533–550.
  6. Saigal R, Mittal M, Kansal A, et al. Fat embolism syndrome. J Assoc Physicians India. 2008; 56: 245–249.
  7. Eriksson EA, Rickey J, Leon SM, et al. Fat embolism in pediatric patients: an autopsy evaluation of incidence and etiology. J Crit Care. 2015; 30(1): 221.e1–221.e5.
  8. Blokhuis TJ, Pape HC, Frölke JP. Timing of definitive fixation of major long bone fractures: Can fat embolism syndrome be prevented? Injury. 2017; 48 Suppl 1: S3–S6.
  9. Gurd AR, Wilson RI, Gurd AR, et al. Fat-embolism syndrome. Lancet. 1972; 2(7770): 231–232.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl