The classical syndrome of fat embolism is characterized by the triad of respiratory failure, neurologic dysfunction and the presence of a petechial rash. Fat embolism syndrome (FES) occurs most commonly following orthopedic trauma, particularly fractures of the pelvis or long bones, however non-traumatic fat embolism has also been known to occur on rare occasions. Because no defi nitive consens...

A 40-year-old man who sustained polytrauma presented with comminuted fractures of both right tibia and femur to the emergency room (ER). He had no evidence of head injury and was admitted for surgical fixation. Twelve hours after admission he developed dyspnea and while awaiting surgery his sensorium gradually declined over the next 24 h. Examination revealed a pulse rate of 130 bpm, blood pres...

1 Reid J. Mid-systolic clicks. S African Med J 1961; 35: 353 2 Barlow J, Pocock W, Marchand P, et al. The significance of late systolic murmurs. Am Heart J 1963; 66:443-52 3 Markiewicz W, Stoner J, et al. Mitral valve prolapse in one hundred presumably healthy young females. Circulation 1976; 53:464-73 4 Procacci P, Savran S, et al. Prevalence of clinical mitral valve prolapse in 1169 young wom...

The initial symptoms are probably caused by mechanical occlusion of multiple blood vessels with fat globules that are too large to pass through the capillaries. The vascular occlusion in fat embolism is often temporary or incomplete, as fat globules do not obstruct capillary blood flow completely because of their fluidity and deformability. The late presentation is thought to be a result of hyd...

The initial symptoms are probably caused by mechanical occlusion of multiple blood vessels with fat globules that are too large to pass through the capillaries. The vascular occlusion in fat embolism is often temporary or incomplete, as fat globules do not obstruct capillary blood flow completely because of their fluidity and deformability. The late presentation is thought to be a result of hyd...

Fat embolism syndrome (FES) is a serious clinical disorder occurring after trauma, orthopedic procedures and rarely in non-traumatic patients. Fat emboli develop in nearly all patients with bone fractures, but they are usually asymptomatic. Small number of patients develop signs and symptoms of various organ system dysfunction due to either mechanical obstruction of capillaries by fat emboli or...

Fulminant fat embolism is well recognised although uncommon. This case report of a patient developing pulmonary oedema during surgery and anaesthesia and dying four hours later is rare, unusual and disturbing. Two similar but non-fatal cases, both young males, of intraoperative pulmonary oedema associated with closed fracture reductions, where fat embolism was implicated, have been previously r...

A healthy 22-year-old woman developed respiratory failure and brain death within 48 h of bilateral tibial fractures. Autopsy showed fat embolism in the lung and brain, and a large patent foramen ovale that may have contributed to massive cerebral fat embolism.

Fat embolism to the systemic circulation in polytrauma patients is very common. The fat embolism syndrome (FES), however, is a rare condition. We describe a case of traumatic femur fracture with FES that was presented as acute tonsillar herniation (coning) and brain death postoperatively. We believe that in this case the prone position and moderate hypercapnia contributed to the acute coning.

BACKGROUND Fat embolism syndrome is the result of systemic manifestations of fat emboli in the microcirculation. Duchenne muscular dystrophy is a condition that increases the risk of fracture resulting in fat emboli. CASE REPORT We describe a patient with Duchenne muscular dystrophy who exhibited cardiopulmonary, neurologic, and ophthalmologic sequelae consistent with fat emboli syndrome afte...