Liposuction-induced fat embolism syndrome

Description

Three days after undergoing an elective liposuction procedure, a 60-year-old woman presented to her local emergency department with shortness of breath and lethargy.

Physical examination was remarkable for abdominal distention, bilateral lower extremity swelling and hypoxaemia. Bilevel positive airway pressure (BiPAP) trial was initiated but it was unable to sustain adequate oxygen saturation; consequently, the patient was intubated and mechanically ventilated. Pulmonary thromboembolism was suspected, but a chest CT scan was contraindicated due to acutely poor kidney function. Therefore, heparin infusion was introduced, but the patient further deteriorated and expired shortly thereafter.

Medical autopsy was conducted to determine the cause of death. Gross findings were significant for acute pulmonary thromboemboli of the segmental and subsegmental arteries of the bilateral lungs and pulmonary lobar consolidation. Surprisingly, brain sectioning revealed diffuse, petechial haemorrhages of the white matter of the cerebral cortex, cerebellum and spinal cord (figure 1).

Figure 1

White matter...

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