Diagnostic / therapeutic accidents
Veronica Lever, Francesco Erdini, Claudio Ghimenton, Luca Novelli, Matteo Brunelli, Mattia Barbareschi, Guido Mazzoleni, Elisa Vermiglio, Alessandro Mantovani, Luca Cima, Giovanni Valotto, Albino Eccher
Pathology Unit, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
Am J Case Rep 2018; 19:744-747
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