電撃型脂肪塞栓症候群の1例

A case of fulminant fat embolism syndrome

脂肪塞栓症候群（fat embolism syndrome：FES）は長管骨骨折や整形外科手術，特に髄内固定術後に発症する多臓器障害を伴う症候群である^1）。長管骨骨折ではほぼすべての症例で脂肪塞栓を生じるが，FESの発症率は1％未満とされる^2）。

Fat embolism syndrome（FES）is a multisystem disorder that occurs following long bone fractures or orthopedic procedures, particularly intramedullary nailing. Although fat embolism occurs in nearly all cases of long bone fracture, the incidence of clinically apparent FES is less than 1％. Typically, FES develops after an asymptomatic period of 24-72 hours following trauma；however, in rare cases, symptoms appear within 24 hours. This rapidly progressive form is termed fulminant fat embolism syndrome（F-FES）, which progresses rapidly and carries a poor prognosis. We experienced a case of F-FES in a woman in her 20s. On imaging, FES demonstrates interlobular septal thickening, ground-glass opacities（GGO）, consolidation, and small nodules, reflecting edema, hemorrhage, and tissue injury caused by free fatty acids. In F-FES, these findings progress rapidly, corresponding to a fulminant clinical course that necessitates prompt and careful management.