What is a fat embolism?
Fat embolism is an embolic event of fatty material entering the vascular system. The occlusion can affect, among other things, the pulmonary vascular system and possibly also the vascular system of the central nervous system (CNS). This leads to serious complications that can be fatal if undetected.
There are other forms of embolism besides fat embolism. In addition to the classic thrombosis, there is also amniotic fluid embolism, air embolism or bone cement embolism. Like the other forms, fat embolism is most often a pulmonary embolism. The fat-containing material of the embolism can originate from the most diverse organ systems of the human body as a result of the most diverse disease processes. Pathophysiologically, the small pulmonary vessels become occluded with a deterioration of the gas exchange and resulting right heart strain.
Causes
The following is an overview of the most common causes of fat embolism. These will then be explained in more detail.
- Fracture
- Use of a hip prosthesis
- Liposuction
- Pancreatitis
A fat embolism occurs mainly in closed fractures of long tubular bones.
These are mainly the humerus, femur, tibia and fibula. Due to their elongated structure, these contain a relatively long medullary cavity, which is mainly filled with bone marrow containing fatty tissue. If the fracture of these predestined bones is closed, part of this fatty bone marrow can detach into the vascular system.
Fatty embolisms can occur postoperatively in orthopedic and trauma surgery. Here, for example in hip TEP (total endoprosthetics), complications can occur with fat embolism. By inserting the prosthesis shaft into the femoral shaft, a strong pressure is built up on the femoral shaft.
The compression of the fat-containing bone marrow contained in the prosthesis can cause a fat-containing embolus to be released. Heating the bone cement material during the setting phase of hip endoprosthetics can also lead to fat embolism. The overall frequency of fat embolism in hip endoprosthetics is between 1 and 10%.
A fatal outcome occurs at 0.1 to 0.5%. Amputation increases the risk. Liposuction can also lead to the increased release of fatty material, with the development of a fat embolus.
However, the risk here is rather low. Typically, liposuction tends to lead to complications such as acute swelling and inflammation and, in the long term, the formation of skin dents and asymmetries. This topic could also be of interest to you: Breast augmentation with own fatty tissueAcute pancreatitis can also be the cause of a fat embolism, but not pancreatitis.
The pancreas is an organ that secretes certain enzymes of the digestive process. Among these, lipase is particularly important for fat embolism. This enzyme has a central function in the breakdown of fats in the small intestine that are taken in with food. In acute pancreatitis, the lipase is accordingly released in increased amounts, which can result in a fat embolism.
