Medical image of the week: fat embolism

• Main Authors: Kim HJ, Jesinger M, Khosravi M
• Format: Article
• Language: English
• Published: Arizona Thoracic Society 2017-12-01
• Series: Southwest Journal of Pulmonary and Critical Care
• Subjects: fat; embolus; embolism; CT scan; external iliac vein; fat embolism; hip fracture; hypoxemia; systemic inflammatory response syndrome; treatment
• Online Access: http://www.swjpcc.com/imaging/2017/12/27/medical-image-of-the-week-fat-embolism.html

No abstract available. Article truncated after 150 words. A 74-year-old woman presented to the hospital with a left femoral neck fracture after a fall. The next day she underwent an uneventful left hip hemiarthroplasty. About 3 hours postoperatively, she became lethargic, tachycardic, tachypneic, febrile, and hypotensive. An arterial blood gas analysis revealed mild hypoxemia with PaO2 / FiO2 ratio of 270. Hemoglobin decreased from 9.4g/dL to 7.7g/dL postoperatively. A chest x-ray showed only bibasilar opacities. Sepsis, acute postoperative blood loss anemia, and pulmonary embolism (PE) were entertained as a differential diagnosis. The patient was resuscitated with intravenous fluids and packed red blood cells, and was started on broad-spectrum antibiotics. Her hemodynamic status stabilized shortly thereafter. A CT chest with PE protocol and abdomen/pelvis down to thigh level was performed; no PE was identified. It did not show any intraabdominal pathology or signs of hemorrhage. However, it incidentally revealed fat embolus mixed with thrombus in the left common and …