CTICasesPost-operative Permeability Pulmonary Edema / Fat Embolism Syndrome
Imaging findings
Chest radiographs taken over two days following a cervical spine discectomy and fusion demonstrate a rapid onset of bilateral, symmetric, predominantly perihilar opacities without pleural effusions or cardiomegaly. A subsequent CT angiogram shows a diffuse crazy-paving pattern and ground-glass opacities with subpleural sparing. A follow-up CT obtained four days later shows rapid clearance of the parenchymal opacities with mild residual bronchial dilation and perilobular thickening.
Key takeaways
Rapidly developing, symmetric ground-glass opacities following major spine surgery can represent non-cardiogenic permeability edema or a mild, self-limited form of fat embolism syndrome. Extensive spine surgery involving vertebral body instrumentation and pedicle screw placement can mobilize marrow fat into the systemic venous circulation, causing alveolar-capillary barrier injury and permeability edema that typically resolves quickly with supportive care.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Necrotizing Granulomatous Pneumocystis jirovecii Pneumonia (PJP)Infection
- Embolized/Dislodged Transcatheter Tricuspid Valve Prosthesis in the Coronary SinusIatrogenic
- Acute Aortic PseudoaneurysmVascular
- Left Superior Vena Cava and Hemiazygos Continuation of the Inferior Vena CavaCongenital
- Fat Embolism SyndromeTrauma
- Tracheal Bronchus, Bilobed Right Lung, and Left Lung HypoplasiaCongenital
- Esophageal Traction Diverticulum Secondary to HistoplasmosisInfection
- Cannonball Pulmonary Metastases from Testicular Mixed Germ Cell TumorNeoplastic
See all cases from June 5, 2021 →
Related Trauma cases
- CPR-Related Thoracic Injuries
- Systemic-to-Pulmonary Arterial Fistulae from Thoracic Trauma
- Cervical Esophageal Perforation from Ingested Glass Foreign Body
- Posterior Shoulder Dislocation with Reverse Bankart and Humeral Fracture
- Traumatic Extrapleural Hematoma from Intercostal Vessel Injury
- Posterior Sternoclavicular Joint Dislocation