7.Pulmonary hemorrhagic infarction due to fat embolism and thromboembolism after maxillofacial plastic surgery: a rare case report.
Dong-hua ZOU ; Yu SHAO ; Jian-hua ZHANG ; Zhi-qiang QIN ; Ning-guo LIU ; Ping HUANG ; Yi-jiu CHEN
Journal of Forensic Medicine 2012;28(5):375-378
Pulmonary fat embolism (PFE) and pulmonary thromboembolism (PTE) are common post-operative complications of orthopedic surgical procedures, but are reported less often following maxillofacial plastic surgical procedures, especially with respect to PFE. Thrombi, or together with fat emboli in pulmonary vessels can induce hemorrhagic infarction and cause death. Herein this report introduced a death due to pulmonary hemorrhagic infarction following maxillofacial plastic surgery. The female patient underwent several osteotomies of the mandible, zygomas and autologous bone grafting within a single operation. The operative time was longer than normal and no preventive strategies for pulmonary embolism were implemented. The patient died 20 days after hospital discharge. The autopsy confirmed pulmonary hemorrhagic infarction. The fat emboli and thrombi were also noted in the pulmonary vessels, which were thought to have resulted from the maxillofacial osteotomy. Suggestions were offered to forensic pathologists that risk factors of PFE and PTE, such as the type and length of surgery, the surgical sites, and the preventive strategies, should be considered when handling deaths after maxillofacial operations.
Adult
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Autopsy
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Cause of Death
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Embolism, Fat/complications*
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Fatal Outcome
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Female
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Forensic Pathology
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Humans
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Infarction/etiology*
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Maxillary Osteotomy
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Postoperative Complications
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Pulmonary Embolism/complications*
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Surgery, Plastic/adverse effects*
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Thromboembolism/complications*
9.A case of nephrotic syndrome associated with protein S deficiency and cerebral thrombosis.
Kyung Soon SONG ; Dong Il WON ; An Na LEE ; Chung Ho KIM ; Jin Soo KIM
Journal of Korean Medical Science 1994;9(4):347-350
Protein S is found in two forms in plasma; as free and functionally active protein S, and complexed to C4b-binding protein. Patients with nephrotic syndrome are at risk for arterial and venous thrombosis at various localizations, and acquired protein S deficiency due to the selective urinary loss of the free form may be a risk factor for the development of thromboembolic complications. We report a case of cerebral arterial thrombosis associated with decreased level of free protein S antigen (44%) in a 39-year-old female patient with nephrotic syndrome.
Adult
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Case Report
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Female
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Human
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Intracranial Embolism and Thrombosis/*etiology
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Nephrotic Syndrome/*complications
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Protein S Deficiency/*complications
10.A Case of Pulmonary Thromboembolism in Active Ulcerative Colitis.
Jae Han PARK ; Gueng Sung CHOI ; Myoung Seok KIM ; Hyung Keun KIM ; Young Seok CHO ; Seong Hyun SON ; Chang Wook KIM ; Hiun Suk CHAE ; Chang Don LEE ; Kyu Young CHOI ; In Sik CHUNG
The Korean Journal of Gastroenterology 2005;45(4):301-305
Thromboembolic disease is a significant cause of morbidity and mortality in patients with inflammatory bowel disease. The reported incidence is 1-6%. The most common thromboembolic complications are deep venous thrombosis of legs and pulmonary thromboembolism. Cerebral thrombosis, portal vein thrombosis, retinal venous thrombosis and arterial thrombosis were also reported. We experienced a case of ulcerative colitis complicated with pulmonary thromboembolism. The patient was a 70-year-old woman who was diagnosed as ulcerative colitis on colonoscopy. We used prednisolone and sulfasalazine for the treatment of ulcerative colitis. Twenty five days later, she complained of abrupt dyspnea and chest pain. Chest CT and ventilation-perfusion scan revealed a thromboembolism in both lung. After the treatment of heparin & warfarin therapy, follow-up chest CT showed much regressed pulmonary thromboembolism. We report a 70-year-old woman with ulcerative colitis complicated with pulmonary thromboembolism and treated with heparin & warfarin therapy successfully.
Aged
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Colitis, Ulcerative/*complications
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English Abstract
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Female
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Humans
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Pulmonary Embolism/*complications