A rare case of pulmonary fat embolism with acute respiratory distress syndrome after thigh fat circumferential extraction and hip fat autologous transplantation.

Abstract

Pulmonary fat embolism is the most severe form of fat embolism syndrome and typically occurs after fractures. However, it is not commonly reported in patients who have undergone liposuction and fat transplantation. A female patient in her early 40s was admitted to the hospital with chest tightness and shortness of breath that had lasted 2 h. Liposuction and fat transplantation (thigh fat circumference, buttock fat transplantation, and filling) were performed under general anesthesia before disease onset; subsequently, she experienced chest tightness and shortness of breath and exhibited decreased oxygen saturation in the peripheral blood. Chest computed tomography combined with red oil O staining of bronchoalveolar lavage fluid samples enabled early and rapid diagnosis of pulmonary fat embolism. The patient was treated with noninvasive mechanical ventilation and short-term glucocorticoid therapy, following which she showed rapid recovery. Considering that the clinical diagnosis of pulmonary fat embolism is very challenging and this condition is commonly misdiagnosed or missed, early diagnosis and appropriate treatment are critical. We aimed to enhance clinicians' knowledge and understanding of pulmonary fat embolism to facilitate early diagnosis and treatment.