A case of fatal fulminant fat embolism syndrome following multiple fractures resulting from a fall

Abstract

Fat embolism syndrome is a life‐threatening condition in which fatty substances enter the circulation and cause respiratory distress and neurological symptoms. It can occur following trauma and severe fat embolism occurring soon after trauma is known as fulminant fat embolism syndrome. Although fat staining of the lungs is helpful for diagnosing fat embolism syndrome at autopsy, clinical and other information is needed to determine the relationship between cause of death and the syndrome. In this report, we describe the macroscopic, microscopic, and computed tomography (CT) findings specific for fat embolism that were observed in a patient with fulminant fat embolism syndrome who died soon after the injury. An 85‐year‐old woman fell from a bath stretcher during assisted bathing and died 3 h later. Autopsy revealed fractures of the left femoral neck and other bones, as well as large amounts of fat‐like material in the right and left pulmonary arteries. Histological examination of the lung with Oil red O staining showed extensive fat vacuoles. Based on these findings and postmortem CT images of the fractures and fatty globules in the pulmonary arteries detected prior to death, the cause of death was determined to be blunt force trauma, with fat embolism syndrome playing a significant role. This case is an example of fulminant fat embolism, which can be fatal in a short period of time, and demonstrates that CT performed postmortem but before autopsy can be useful in detecting fat embolism syndrome due to trauma.

A Case of Fulminant Fat Embolism Syndrome With Very Early Onset After Femoral Neck and Sacral Fractures

“…Among the reported fulminant FES cases, seven cases [13][14][15][16][17][18], including our case, were identified that developed less than 3 h after injury, with our case being the earliest after injury (Table 2). Most of the fulminant FES cases were severely ill. Another possible mechanism for cerebral fat embolization is that pulmonary fat embolization increases right atrial pressure, causing the leftover patent foramen ovale (PFO) to open, resulting in a right-to-left shunt, which allows fat droplets to flow into the arterial side and cause cerebral infarction [19].…”

Detection of Chylous Plasma Based on Machine Learning and Hyperspectral Techniques

“…3 Chylous blood should not be used for clinical purposes. 4 Its injection into the patients causes adverse reactions, such as allergy, fever, and fat embolism, 5 thereby further harming the patient. Therefore, a convenient and fast method for differentiating between chylous and normal healthy blood should be urgently developed.…”