Pediatric Anesthesia and Critical Care Journal (PACCJ) (Jul 2021)

Fat embolism following traumatic injury with cerebral embolism and stroke in the presence of a patent foramen ovale

  • L. DeLong,
  • J. D. Tobias

DOI
https://doi.org/10.14587/paccj.2021.11
Journal volume & issue
Vol. 9, no. 2
pp. 65 – 68

Abstract

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Fat embolism syndrome (FES) most commonly occurs 24-48 hours following trauma or orthopedic surgery. The signs and symptoms of FES are often difficult to identify or may be attributed to the primary event or a comorbid condition. Clinical manifestations vary depending on the clinical scenario, generally including hypoxemia, respiratory insufficiency, a petechial rash, and fever. We report a 13-year-old adolescent who presented with multiple end-organ effects including an embolic stroke in the presence of a patent foramen ovale related to FES following traumatic injury and orthopedic surgery. The proposed pathophysiological mechanisms and etiology of FES are reviewed, diagnostic criteria and work-up presented, and therapeutic interventions discussed.

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