Fat Embolism

Updated: Feb 02, 2024
  • Author: Constantine S Bulauitan, MD; Chief Editor: Vincent Lopez Rowe, MD, FACS  more...
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Overview

Practice Essentials

For those who manage major trauma victims, the topic of fat embolism weighs heavily on the mind. The incidence of this problem can approach 90% in patients who have sustained major injuries. If it progresses to the rare clinical entity known as fat embolism syndrome (FES), [1] a systemic inflammatory cascade affecting multiple organ systems, morbidity and mortality are high. Accordingly, swift diagnosis and treatment of fat embolism are paramount for ensuring the survival of this patient population. [2]

Ernst Von Bergmann, in 1873, was the first person credited with making a clinical diagnosis of fat embolism. He did this on the basis of knowledge gathered from experiments with cats 10 years previously, in which he injected them with intravenous oils. Von Bergmann later described a patient who fell off a roof and sustained a comminuted fracture of the distal femur; 60 hours after the injury, the patient developed dyspnea, cyanosis, and coma. [2]

The diagnosis of FES is mainly a clinical one. It is dependent on clinical identification of dyspnea, petechiae, and cognitive dysfunction in the first few days following trauma, long-bone fracture, or intramedullary surgery. Various laboratory studies and imaging modalities exist to aid in its discovery (see Presentation

 
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