A Fatal Case of Concomitant Cerebral and Pulmonary Fat Embolism After Abdominal Liposuction in a Patient with a History of Prior Stroke and Patent Foramen Ovale: A Case Report
Ashok Paudel, Zeynep Tuğçe Sarıkaya, M. Erkan Ekicibası, Seher İrem Kıran
Acibadem Mehmet Ali Aydınlar Üniversitesi
Giriş:
Liposuction is an elective esthetic procedure with rising frequency. The first case of liposuction-induced fat embolism was reported by Christman (1). Fat embolism (FE) commonly occurs in clinical conditions like long bone fractures, intramedullary nailing, arthroplasty (2). FE might pass into the systemic circulation in the presence of venous to arterial (v-a) or an intracardiac right to left shunt like atrial septal defect (ASD) and patent foramen ovale (PFO) (3,4). The objective of this case report is to emphasize rare complications that could be encountered in patients with special conditions like prior history of stroke and PFO during liposuction.
Olgu: A 69-year-old female patient with a history of breast cancer and ischaemic stroke without sequelae developed left hemiplegia and confusion 6 hours after an abdominal liposuction. Cranial Computed Tomography (CT) confirmed embolism in the right main cerebral artery (MCA) and anterior cerebral artery (ACA).Thoracic CT showed fat embolism in pulmonary artery trases. Transesophageal echocardiography (TEE) revealed PFO demonstrated by colour doppler and contrast injection.
Tartışma ve Sonuç: Fat embolism after liposuction is not a rare entity and could be life threatening (5,6,7).
Transesophageal echocardiography is neither feasible nor indicated before liposuction procedure. But every patient should be evaluated on an individual basis according to their history, risk factors and prior medical condition. Transesophageal echocardiography before the procedure would have revealed the patent foramen ovale and the procedure could have either been withheld or all the risk could have been discussed with the patient and relatives.
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