Fat Embolism

Book
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
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Excerpt

Fat embolism (FE) and fat embolism syndrome(FES) are a clinical phenomenon that are characterized by systemic dissemination of fat emboli within the system circulation. The dissipation of fat emboli will disrupt the capillary bed and affect microcirculation, causing a systemic inflammatory response syndrome. End-organ manifestation typically will involve the following:

  1. Skin and integumentary organ

  2. Central nervous system

  3. Respiratory system lungs

  4. Eyes retina

Fat embolism syndrome is most common in patients with orthopedic trauma. It also can occur in nontraumatic patients. The following nontraumatic conditions can cause fat embolism syndrome:

  1. Acute or chronic pancreatitis

  2. Bone marrow transplant

  3. Liposuction

In most instances, diagnosis is usually established during the autopsy.

Fat embolism is the presence of fat globules in microcirculation whereas fat embolism syndrome is a systemic manifestation of dissemination of fat molecules or globules in microcirculation. Fat embolism syndrome is a continuum of fat embolism.

Zenker first described the clinical presentation of fat embolism syndrome in 1863 in a patient suffering from crush injury. In 1873, Von Bergmann clinically diagnosed the condition for the first time. Since the initial description by Zenker and Von Bergmann, several articles and studies have been published on this diseases entity. In the early 70's, Gurd proposed a clinical criterion for the diagnosis of fat embolism syndrome. This was later modified by Wilson in 1974 in conjunction with Gurd and is the most commonly used clinical criteria for diagnosis.

Since the majority of reported cases of fat embolism is seen in patients with orthopedic trauma,most research on this condition is in orthopedic patients.

Even though the clinical criteria proposed by Gurd et al. and Wilson can help or aid in the diagnosis, fat embolism syndrome still poses a major diagnostic challenge to most clinicians.

Publication types

  • Study Guide