tailieunhanh - Báo cáo y học: "Post-traumatic fulminant paradoxical fat embolism syndrome in conjunction with asymptomatic atrial septal defect: a case report and review of the literature"

Tham khảo luận văn - đề án 'báo cáo y học: "post-traumatic fulminant paradoxical fat embolism syndrome in conjunction with asymptomatic atrial septal defect: a case report and review of the literature"', luận văn - báo cáo phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Mueller et al. Journal of Medical Case Reports 2011 5 142 http content 5 1 142 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Post-traumatic fulminant paradoxical fat embolism syndrome in conjunction with asymptomatic atrial septal defect a case report and review of the literature Franz Mueller Christian Pfeifer Bernd Kinner Carsten Englert Michael Nerlich and Carsten Neumann Abstract Introduction Fat embolism syndrome with respiratory failure after intramedullary nailing of a femur fracture is a rare but serious complication in trauma patients. Case presentation We present the case of a 20-year-old Caucasian man who experienced paradoxical cerebral fat embolism syndrome with fulminant progression after intramedullary nailing of a femur fracture in conjunction with a clinically asymptomatic atrial septal defect in a high position resulting in a right-to-left shunt. Conclusion Fat embolism syndrome may occur as a fulminant complication following femoral fracture repair in the presence of a concomitant atrial septal defect with right-to-left shunt. Thus in patients with cardiac right-to-left shunts femurs should not be nailed intramedullary not even in cases of isolated injuries. Introduction Fat embolism is caused by bone marrow components in the form of cell debris and yellow bone marrow entering into the systemic circulation and into the parenchyma of the lungs via the venous sinus 1 . Fat embolism syndrome FES however is the symptomatic manifestation of fat embolism with symptoms such as respiratory failure thrombocytopenia or cerebral confusion 2 which occur within 48 hours after trauma in most patients 2 3 . The occurrence of FES after intramedullary nailing of femur fractures is a rare but dreaded complication. Therefore the application of an external fixation as an initial treatment is particularly recommended for multiple-trauma patients. However scientific evidence from prospective multi-center studies is still required