Case report: cerebral and pulmonary fat embolism after facial autologous fat injection
10.3760/cma.j.cn114453-20220616-00184
- VernacularTitle:面部自体脂肪注射后脑和肺部脂肪栓塞1例
- Author:
Jun ZUO
1
;
Shaolin MA
;
Yihong QU
;
Weiting FANG
;
Yong YOU
;
Hongju XIE
Author Information
1. 海南医学院第二附属医院整形外科，海口 570100
- Keywords:
Embolism, fat;
Cerebral embolism;
Pulmonary embolism;
Autologous fat injection;
Autopsy;
Pathology
- From:
Chinese Journal of Plastic Surgery
2023;39(2):176-181
- CountryChina
- Language:Chinese
-
Abstract:
Cerebral fat embolism (CFE) combined with pulmonary fat embolism (PFE) is an extremely rare and serious complication after fat injection. In order to improve the understanding of the mechanism of this complication, this article reported the diagnosis, treatment and pathological results of a patient with CFE and PFE after facial autologous fat injection. A 34-year-old female underwent an injection of autologous fat in her right cheek at another institution in March 2021 and developed into a coma. 1.5 hours later, she was taken to the Emergency Department of the Second Affiliated Hospital of Hainan Medical University. CT revealed a massive infarction in the right cerebral hemisphere and bilateral acute pneumonia. The patient was treated with dehydration, anti-infection, anticoagulation and microcirculation improvement in the intensive care unit. But the patient died due to the critical condition. Postmortem autopsy and histopathological examination, revealed ischemic stroke with hemorrhagic transformation, and pulmonary embolism with acute pneumonia. It was speculated that the fat embolus passed through the damaged main trunk or branch of the right facial artery, and then retrograde to the right external carotid artery, common carotid artery and internal carotid artery to cause middle cerebral artery occlusion. At the same time, the embolus returned to the right atrium along with the accompanying vein of the above artery, and reached the pulmonary vascular bed through the pulmonary circulation, resulting in pulmonary embolism. Plastic surgeons should have extensive knowledge with the anatomical structure of facial blood vessels, master the injection techniques, and improve the awareness of fat embolism when performing facial fat transplantation.
