34 years old male with femur shaft fracturedevelops petechiae over chest 4 days after the injury. What is the most probable diagnosis?
Ans. is 'a' i.e., Fat embolism o Fat embolism means circulation of fat globule away from its site of origin,o When fat embolism causes symptoms it is called fat embolism syndrome,o Causes of fat embolism1. Fracture of long bone (most common) - Blunt trauma2. Soft tissue trauma3. Bums4. Parenteral lipid infusion5. Sickle cell crisis6. Recent Corticosteroid adn7. Acute pancreatitis8. D.M.9. Liposuction10. Decompression sicknesso Fracture s of bone is the most common cause of fat embolism.o Amongst the long bones, femur fracture is associated with fat embolism most commonly.o Multiple fractures increase the risk of fat embolism.Clinical manifestations of fat embolismo Clinical features are evident within 1-3 days. About 25 percent of patients develop symptoms within 12 hours and 75 percent within 36 hours. Occasionally the onset may be delayed for several days and some patients may go unnoticed initially. Early warning signs are a slight rise in temperature (pyrexia) and tachycardia.o The classical triad of fat embolism syndrome isRespiratory symptoms : Dyspnea, tachypnea, cyanosis, ARDS, low PO2.Neurological symptoms : Confusion, disorientation, restlessness, irritation, delirium, convulsion, coma.Petechial rash : In axilla, neck, periumblical area, conjunctiva of lower lid, retina, front & beck of chest, shoulder.
Fat embolism
Air embolism
Thrombocytopenia
Hypocomplimentemia
Fracture Shaft Femur