ROENTGENOGRAPHIC SIGNS OF POSTTRAUMATIC FAT EMBOLISM

Abstract

Recognizing the syndrome of posttraumatic fat embolism can be difficult. The onset of tachypnea, pulmonary rales, cyanosis, and stupor is frequently so rapid and dramatic that all efforts must be directed toward resuscitation. In such instances, the physician's use of pressure-or volume-cycled respirators to assist or control the patient's ventilation can be lifesaving. But among war casualties and accident victims, the signs of pulmonary injury from fat embolism may resemble those from thoracic trauma or heart failure. And, in older patients, thromboembolism must also be considered. Moreover, the cerebral injury from fat embolism may be confused with epidural hematoma or cerebral contusion. Tests for fat globules in the urine or elevated serum lipase activity are time consuming and occasionally misleading. The appearance of the patient's chest roentgenogram, however, often provides a clue to rapid diagnosis. A widespread loss of pulmonary radiolucency, obliteration of the vascular markings, and diffuse parenchymal infiltrates