SciELO - Scientific Electronic Library Online

 
vol.19 número2An unusual cause of haematuria - case report índice de autoresíndice de assuntosPesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

  • Não possue artigos similaresSimilares em SciELO

Compartilhar


Angiologia e Cirurgia Vascular

versão impressa ISSN 1646-706X

Angiol Cir Vasc vol.19 no.2 Lisboa jun. 2023  Epub 30-Ago-2023

https://doi.org/10.48750/acv.528 

Vascular image

Fat embolism in the femoral veins

Roberto Cunha1 
http://orcid.org/0000-0003-2252-9872

Manuel Silva1 

Pedro Sousa1 
http://orcid.org/0000-0001-6999-3539

Mafalda Correia1 
http://orcid.org/0000-0002-1134-7400

Isabel Vieira1 
http://orcid.org/0000-0002-8131-6116

Isabel Cássio1 

Nelson Oliveira1 
http://orcid.org/0000-0002-6737-3691

Emanuel Dias1 

1. Serviço de Angiologia e Cirurgia Vascular do Hospital Divino Espírito Santo, Ponta Delgada, Portugal


Figure 1 

Polytraumatized after a 10-meter fall, which resulted in multiple fractures, including the right femur and pelvis. A 24-hour thoracoabdominal-pelvic computed tomography showed non-occlusive fat embolism in both femoral veins, with a length of 1.7cm on the right and 3.7cm on the left. This diagnosis was based on the identification of emboli with fat-like density. He was treated with elastic compression (18mmHg) with no evidence of pulmonary embolism. Placement of an inferior vena cava filter was not considered necessary given the lack of evidence. Anticoagulation was contraindicated in view of trauma plus hemothorax and grade IV hepatic lacerations.

Fat embolism is rarely diagnosed. Asymptomatic in the hyperacute phase, can trigger a syndrome characterized by respiratory distress, neurological symptoms and petechiae. In bone fractures, the bone marrow accesses small adjacent venules, developing systemic inflammatory reaction and widespread platelet aggregation, typically 24-72h after the embolism.

Conflicts of interest

None

Funding

None

Received: December 26, 2022; Revised: March 02, 2023; Accepted: March 20, 2023

Corresponding Author: Roberto Cunha | roberto.sb.cunha@azores.gov.pt Angiology and Vascular Surgery Department, Hospital do Divino Espírito Santo (HDES) Av. D. Manuel I, 9500-370, Ponta Delgada, São Miguel Island, Azores, Portugal

Creative Commons License This is an open-access article distributed under the terms of the Creative Commons Attribution License