25 June 2018 : Case report
Diagnostic / therapeutic accidentsVeronica Lever1BEF, Francesco Erdini1AB, Claudio Ghimenton1AB, Luca Novelli2AB, Matteo Brunelli1AB, Mattia Barbareschi3AB, Guido Mazzoleni4ABD, Elisa Vermiglio5C, Alessandro Mantovani6CD, Luca Cima1E, Giovanni Valotto1BEF*, Albino Eccher1AEG
Am J Case Rep 2018; 19:744-747
BACKGROUND: Fat embolism syndrome is a well-known complication in orthopedic and trauma surgery, caused by a massive release of fat into the circulation that can lead to cardiopulmonary insufficiency and multiorgan failure.
CASE REPORT: We present the case of a 72-year-old man with osteoarthritis who underwent an elective right cementless total hip arthroplasty. Two hours after surgery, the patient lost consciousness and was found hypotensive and with reduced oxygen saturation, with a severe right heart dilatation at echocardiographic evaluation. Death occurred after cardiopulmonary resuscitation attempts. Post-mortem microscopic examination revealed that the final cause of death was pulmonary fat embolism associated with coronary amyloidosis and atherosclerosis.
CONCLUSIONS: This case called our attention on the sudden onset of fat embolism syndrome after arthroplasty and the insidious nature of amyloidosis infiltrative disease. The autopsy findings substantially aided understanding the immediate cause of death.
Keywords: Amyloidosis, Embolism, Fat, Orthopedics, Pulmonary Embolism
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