Concomitant Fat Embolism Syndrome and Pulmonary Embolism in an Orthopedic Trauma Patient.

Abstract

Simultaneous acute pulmonary embolism (PE) and fat embolism syndrome (FES) in a trauma patient is very rare. Acute PE is a frequent complication and, at times, a fatal disease. Its most common presenting symptom is dyspnea, followed by chest pain and cough. FES is a rare clinical syndrome defined by the presence of fat globules in the pulmonary circulation. It can occur in a vast variety of clinical conditions, especially in those where fat is manipulated. Almost all cases of FES are due to long bone and pelvic fractures. It is essential to differentiate between FES and PE, as the management of both these conditions is altogether different. PE and FES are usually seen separately, and it is rare to have concomitant FES and PE in the same patient. There is a paucity of case reports in the literature wherein patients developed concomitant FES and PE. We present a case of a roadside traffic accident (RTA) with long bone fractures, who developed this unusual and rarer clinical entity of concomitant FES and PE in the perioperative period. Its presentation, diagnosis, and successful management are discussed, along with a literature review.