Fat embolism syndrome: State-of-the-art review focused on pulmonary imaging findings

被引:61
作者
Newbigin, Katrina [1 ]
Souza, Carolina A. [2 ,4 ]
Torres, Carlos [2 ,4 ]
Marchiori, Edson [3 ]
Gupta, Ashish [2 ,4 ]
Inacio, Joao [2 ,4 ]
Armstrong, Mitchel [2 ,5 ]
Pena, Elena [2 ,4 ]
机构
[1] Wesley Hosp, Dept Radiol, 2 Chasley St, Brisbane, Qld 4066, Australia
[2] Ottawa Hosp, Ottawa, ON, Canada
[3] Univ Fed Rio de Janeiro, Dept Radiol, Rua Thomaz Cameron 438, BR-25685120 Rio De Janeiro, RJ, Brazil
[4] Univ Ottawa, Ottawa Hosp, Ottawa Hosp Res Inst, Dept Med Imaging, 501 Smyth Rd,Box 232, Ottawa, ON K1H 8L6, Canada
[5] Univ Ottawa, Ottawa Hosp, Ottawa Hosp Res Inst, Dept Orthoped Surg, 501 Smyth Rd,Box 232, Ottawa, ON K1H 8L6, Canada
关键词
Fat embolism; Non thrombotic pulmonary embolism; High resolution computed tomography; Pulmonary imaging; PATENT FORAMEN OVALE; HIGH-RISK PATIENTS; COMPUTED-TOMOGRAPHY; FEMORAL FRACTURES; TRAUMA PATIENTS; CT FINDINGS; BRONCHOALVEOLAR LAVAGE; DIAGNOSIS; CORTICOSTEROIDS; PATHOGENESIS;
D O I
10.1016/j.rmed.2016.01.018
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Fat embolism syndrome (FES) is a rare but potentially fatal complication of trauma or orthopedic surgery, which presents predominantly with pulmonary symptoms. Modern intensive care has improved the mortality rates, however diagnosis remains difficult, relying predominantly on a combination of a classic triad of symptoms and non-specific, but characteristic radiological features. The aim of this review is to describe the main clinical and imaging aspects of FES, ranging from pathophysiology to treatment with emphasis on pulmonary involvement. Methods: We reviewed the currently published literature on the main characteristics of FES. Results: In a hypoxic patient with recent trauma or orthopedic surgery, the presence of diffuse, well-demarcated ground glass opacities or ill-defined centrilobular nodules on computed tomography (CT) of the chest are suggestive of FES. Conclusions: Combination of the classic clinical syndrome in the appropriate clinical setting, together with the characteristic imaging findings on chest CT, can help to achieve the correct diagnosis. Management remains predominantly supportive care, and the benefit of medical therapies such as corticosteroids and heparin remains unclear. (C) 2016 Elsevier Ltd. All rights reserved.
引用
收藏
页码:93 / 100
页数:8
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