Abstract

A case of fatal pulmonary fat embolism is reported in view its controversial pathogenesis and long survival after trauma. The patient was a 48 year old male was admitted because of car accident. On Physical examination, right thigh showed massive swelling and bony discontinuity of the femur. The X-ray film revealed comminuted fractures in the 1/3 of upper shaft and 1/5 of lower shaft of the femur. Skeletal traction was started on the day of admission under the diagnosis of segmental fracture of right femur. On the 7 th day, open reduction with intramedullary nailing and hip spica cast was done. Post-operative course was uneventful until the 23rd postoperative day when the patient expired suddenly with respiratory difficulty. The postmortem examination performed on 11 days after the death disclosed widespread pulmonary fat embolism associated with massive edema. The brain was free from fat embolism.