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A case of life-threatening intraoperative diffuse alveolar hemorrhage during a femur fracture operation with suspected fat embolism - A case report -
Anesth Pain Med 2018;13(1):77-81
Published online January 31, 2018
© 2018 Korean Society of Anesthesiologists.

Jong Hui Suh1, Bum-sik Lee2, Soon Ju Baek3, Soo Kyung Park3, and Eun Jung Cho3
Departments of 1Thoracic and Cardiovascular Surgery, 2Orthopaedic Surgery, and 3Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
Correspondence to: Eun Jung Cho, M.D., Ph.D.
Department of Anesthesiology and Pain Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon 21431, Korea
Tel: 82-32-280-5410
Fax: 82-32-518-2718
Received June 5, 2017; Revised September 5, 2017; Accepted September 6, 2017.
cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Diffuse alveolar hemorrhage (DAH) is a rare manifestation of trauma or long bone fracture. A relationship between fat embolism and DAH has been reported. A 73-year-old female developed sudden cardiac arrest during a femur fracture operation. Cardiopulmonary resuscitation (CPR) was repeated for about 130 minutes. During CPR, blood was detected in the endotracheal tube. Diffuse patch ground glass opacity appearance and increased pulmonary artery with bulging of interventricular septum toward the left ventricle were detected on a chest computed tomography scan. After full supportive care including ventilator therapy, the patient’s condition became stabilized and she was extubated after 7 days. We report a case of DAH in the course of a suspected fat embolism during femur fracture operation. Although DAH is a rare manifestation of fat embolism, early diagnosis and aggressive treatment likely can decrease morbidity and mortality.
Key Words : Diffuse alveolar hemorrhage, Embolism, Long bone fracture.

January 2018, 13 (1)
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