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Fat Embolism Syndrome T79.1XXA 958.1

 
ICD-9 Classification / Treatment
Etiology / Epidemiology / Natural History Associated Injuries / Differential Diagnosis
Anatomy Complications
Clinical Evaluation Follow-up Care
Xray / Diagnositc Tests Review References

synonyms:

Fat Embolism Syndrome ICD-10

Fat Embolism Syndrome ICD-9

 

Fat Embolism Syndrome Etiology / Epidemiology / Natural History

  • seen in young people with leg fractures sustained in vehicular accidents and elderly people with hip fractures or after arthroplasty
  • Sixty percent of all cases of FES are seen in the first 24 hours after trauma, and 90% of all cases appear within 72 hours

Fat Embolism Syndrome Anatomy

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Fat Embolism Syndrome Clinical Evaluation

  • Classic triad of hypoxia, confusion, and petechiae appearing in a patient with fractures usually occurs within 48 hours of injury.
  • Respiratory symptoms: cough, dyspnea, hemoptysis, and pleural pain;.
  • Signs include pyrexia, tachycardia, tachypnea, rales rhonchi, and friction rub. 
  • CNS symptoms: confusion, restlessness, stupor, delirium
  • Skin symptoms: petechiae along the anterior axillary folds and in the conjunctiva and retina. 
  • Gurd and Wilson’s criteria
  • Major signs are respiratory insufficiency, cerebral involvement, and petechial rash.
  • Minor signs are fever, tachycardia, retinal changes, jaundice, and renal changes.
  • The diagnosis of FES is made when one major and four minor signs are present.
  • Labs: increase in the A-a O2 gradient, and V/Q inequality, PO2 less than 60 mmHg on room air.
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Fat Embolism Syndrome Xray / Diagnositc Tests

  • Chest X-Rays are often normal or may show an ARDS picture 1-2 days after trauma.

Fat Embolism Syndrome Classification / Treatment

  • Ventilatory support is the treatment of choice
  • surgical stabilization of long bone fractures is beneficial
  • the use of steroids, heparin, or low-molecular weight dextran has not been associated with improved clinical results in any prospective clinical trials

Fat Embolism Syndrome Associated Injuries / Differential Diagnosis

  • Pulmonary embolism

Fat Embolism Syndrome Complications

Fat Embolism Syndrome Follow-up Care

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Fat Embolism Syndrome Review References

  • Gossling HR, Donohue TA: The fat embolism syndrome.  JAMA 1979;241:2740-2742.

 

 

 

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