Fat embolism syndrome in long bone fractures, case report
DOI:
https://doi.org/10.29166/rfcmq.v47i2.3372Keywords:
Lung injury, Embolism, fat, Fractures, bone, seizures, case reportAbstract
Introduction: Fat embolism syndrome is a severe, although rare complication of major trauma. It is triggered by the passage of fat particles into the microcirculation in various organs. The characteristic triad: lung injury, petechial hemorrhage and neurological dysfunction. Its prevalence varies according to the diagnostic criteria and the triggering cause, making its early detection difficult.
Case presentation: Case 1. Patient 22 years old, male, suffered a car accident with open fracture of the right femur, tibia and fibula, surgically resolved, 5 hours after the event he suffered respiratory impairment, conjunctival, thoracic and extremity petechiae; later impaired consciousness, status epilepticus and paroxysmal sympathetic hyperactivity syndrome. Case 2. Patient 29 years old, male, suffered overturning of the vehicle in which he was traveling, suffering closed fractures of the left tibia, fibula and femur, after trauma surgery he suffered impaired consciousness, conjunctival petechiae and hypoxemia.
Diagnoses and interventions: Both patients underwent surgery for trauma resolution within 24 hours, after the appearance of neurological symptoms they underwent neuroimaging finding "star field" pattern, both received corticosteroids.
Results: Case 1 the outcome was vegetative state, Case 2 complete recovery.
Conclusion: Detection is essential to establish early treatment, to plan trauma surgery or to defer it and to estimate prognosis according to evolution. Cerebral fat embolism syndrome is a rare cause of paroxysmal sympathetic hyperactivity syndrome.
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