Indian Journal of Critical Care Case Report

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VOLUME 2 , ISSUE 4 ( July-August, 2023 ) > List of Articles

CASE REPORT

Concomitant Fat Embolism Syndrome and Pulmonary Embolism—A Hidden Enemy in Polytrauma Patient: A Case Report

Suresh Jaganathan, Balaji Thirugnanam, Nitish Mukunthan, Shanmugapriya Senthilkumar

Keywords : Acute pulmonary embolism, Case report, Fat embolism syndrome, Long bone fractures

Citation Information : Jaganathan S, Thirugnanam B, Mukunthan N, Senthilkumar S. Concomitant Fat Embolism Syndrome and Pulmonary Embolism—A Hidden Enemy in Polytrauma Patient: A Case Report. 2023; 2 (4):100-102.

DOI: 10.5005/jp-journals-11006-0065

License: CC BY-NC 4.0

Published Online: 18-08-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Fat embolism syndrome (FES) and pulmonary embolism (PE) are the most common systemic complications seen after a long bone fracture. Though there may be a partial overlap of clinical symptoms and signs, the pathophysiology and management of both entities are totally different. It is important to correctly diagnose the entity to proceed with appropriate treatment. Both complications in most cases occur separately. But in very rare cases both fat embolism and PE coexist together, giving a diagnostic and therapeutic challenge. We present one such rare case of a young female post-road traffic accident with a bilateral tibia fracture who underwent bilateral tibia intramedullary interlocking nailing under regional anesthesia after initial stabilization. Postoperatively patient developed signs of pulmonary thromboembolism which was diagnosed with computed tomography pulmonary angiogram (CTPA). The patient was treated with anticoagulation, and at a later date, she developed signs of encephalopathy. Diagnosis of cerebral fat embolism was made based on magnetic resonance imaging (MRI) brain findings. She had a stormy postoperative period. We hereby describe the challenges we faced in the perioperative period to diagnose and treat her successfully.


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