Despite the controversy over the existence and mechanism of occurrence of fat embolism, the clinical and pathological evidence in support of this entity appears conclusive. Fat embolism occurs more frequently in all types of injury than is generally recognized, and with the increase of highway accidents and the threat of mass trauma its incidence may be expected to increase. Surveys of consecutive trauma cases7 and unselected autopsies2 have shown that in a high percentage of trauma cases fat globules can be demonstrated in the urine and viscera on microscopic examination. In many of these cases clinical manifestations directly attributable to fat embolism are minimal or absent, whereas in others massive involvement produces a fulminating pulmonary-cerebral complex with a high mortality.Fat embolism is so easily overlooked by the clinician or pathologist that its possibility must be kept in mind,13 else the correct diagnosis will be missed.
NELSON TG, BOWERS WF. Fat Embolism LornAn Analysis of Four Fatal Cases. AMA Arch Surg. 1956;72(4):649-658. doi:10.1001/archsurg.1956.01270220097013