Acute Disease ; Humans ; Pulmonary Embolism ; therapy

In this study, we analyzed two cases of pure cerebral fat embolism and reviewed related literatures to explore the pathogenesis, clinical manifestations, diagnosis and treatment of cerebral fat embolism, improve the treatment efficiency and reduce the misdiagnosis rate. In our cases, patients fully returned to consciousness at the different times with good prognosis, normal vital signs and without obvious sequelae. For patients with the limb fractures, who developed coma without chest distress, dyspnea or other pulmonary symptoms 12 or 24 h post injury, cerebral fat embolism should be highly suspected, except for those with intracranial lesions, such as delayed traumatic intracerebral hemorrhage, etc. The early diagnosis and comprehensive treatment can improve prognosis.
Adult ; Embolism, Fat ; diagnosis ; etiology ; therapy ; Humans ; Intracranial Embolism ; diagnosis ; etiology ; therapy ; Male

Adult ; Embolism, Paradoxical ; diagnosis ; therapy ; Humans ; Male ; Pulmonary Embolism ; diagnosis ; therapy

Humans ; Pulmonary Embolism ; diagnosis ; therapy ; Venous Thromboembolism ; diagnosis ; therapy

A paradoxical embolism is defined as a systemic arterial embolism requiring the passage of a venous thrombus into the arterial circulatory system through a right-to-left shunt, and is commonly related to patent foramen ovale (PFO). However, coexisting pulmonary embolisms, deep vein thromboses (DVT), and multipe systemic arterial embolisms, associated with PFO, are rare. Here, we report a patient who had a cryptogenic ischemic stroke, associated with PFO, which is complicated with a massive pulmonary thromboembolism, DVT, and renal infarctions, and subsequently, the patient was treated using a thrombolytic therapy.
Embolism ; Embolism, Paradoxical ; Foramen Ovale, Patent ; Humans ; Infarction ; Kidney Diseases ; Pulmonary Embolism ; Renal Artery ; Stroke ; Thrombolytic Therapy ; Thrombosis ; Venous Thrombosis

The optimal treatment for free-floating massive right heart thrombi remains uncertain. However, they appear to increase the risk of mortality compared to the existence of a solitary pulmonary thromboembolism. Thrombolytic therapy has been shown to be effective in most patients, resulting in complete resolution of the massive thrombus and clinical improvement. We report the echocardiographic disappearance of a free-floating right heart thrombus after thrombolysis, however, the thrombus migrated and resulted in pulmonary thromboembolism. It was successfully removed with surgery.
Embolectomy ; Heart ; Humans ; Pulmonary Embolism ; Thrombolytic Therapy ; Thrombosis

Adult ; Embolism, Amniotic Fluid ; etiology ; therapy ; Female ; Humans ; Pregnancy

Child ; Humans ; Pulmonary Embolism ; diagnosis ; etiology ; therapy ; Risk Factors

A fifty-seven year old female patient visited the emergency department with tachypnea and a decreased mental status. The patient had been receiving fluid therapy at home and a bolus of air was injected into the fluid bottle in order to increase the infusion speed. Chest computed tomography revealed air in the left brachiocephalic vein that was accompanied with pulmonary edema the diagnosis of venous air embolism was made. Venous air embolism can result from various procedures that are performed in almost all clinical specialties and they can be fatal in cases of massive air embolism. Therefore, it is important for all clinicians to be aware of this problem.
Brachiocephalic Veins ; Embolism, Air ; Emergencies ; Female ; Fluid Therapy ; Home Infusion Therapy ; Humans ; Pulmonary Edema ; Pulmonary Embolism ; Tachypnea ; Thorax

OBJECTIVETo summarize the clinical characteristics of mesenteric arterial embolism (MAE) and mesenteric arterial thrombosis (MAT), and to clarify the diagnosis and treatment status of MAE and MAT in China.

METHODSA retrospective analysis of 111 cases suffering from MAE or MAT was performed. Data of these cases were collected from Chinese Journal Full-text Database from 1994 to 2006.

RESULTSThere were 61 cases (54.9%) with MAE and 50 cases (45.1%) with MAT. Fifty-two patients (46.8%) had arterial fibrillation. Ninety-seven cases (87.4%) were diagnosed by exploratory laparotomy or autopsy, and 14 cases (12.6%) by imageology. Embolism or thrombosis in superior mesenteric artery (SMA) accounted for 92.8%, 4.5% in SMA plus inferior mesenteric artery. 15.2%(14/92) necrosis were located in jejunum or ileum, 39.1%(36/92) in jejunum and ileum, 38.0%(35/92) in jejunum, ileum and colon. Thrombolysis or anticoagulation in artery were operated in 7 cases(6.3%). Extraction of embolism or thrombosis in operation were implemented in 18 cases(16.2%). Intestinal resection were finished in 76 cases(68.5%). Sixty-eight patients (61.3%) were misdiagnosed. Sixty-three cases (60.6%) died.

CONCLUSIONThe manifestation of MAE or MAT is quite complicated and changeable, so that many cases are misdiagnosed. The clinic and image characteristics of MAE and MAT have not been well known by doctors.

Embolism, Cholesterol ; diagnosis ; therapy ; Humans ; Mesenteric Vascular Occlusion ; diagnosis ; therapy ; Retrospective Studies ; Thrombosis ; diagnosis ; therapy