A Rare Case of Pulmonary Bone Fragment Embolism - A Case Report

Authors

  • S M Bakkannavar Department of Forensic Medicine and Toxicology, Kasturba Medical College, Manipal, MAHE, Manipal.
  • A Jayakala Department of Forensic Medicine and Toxicology, Kasturba Medical College, Manipal, MAHE, Manipal.
  • D Nayak Department of Pathology, Kasturba Medical College, Manipal, MAHE, Manipal.
  • S Shetty Department of Orthopaedics, Kasturba Medical College, Manipal, MAHE, Manipal.
  • A K Bhat Department of Orthopaedics, Kasturba Medical College, Manipal, MAHE, Manipal.

DOI:

https://doi.org/10.48165/jiafm.2023.45.4.26

Keywords:

Bone fragment, Embolism, Pneumonia, Autopsy, Case report

Abstract

Bone fragment embolism (BFE) is a type of osseous related non-thrombotic pulmonary embolism (NTPE). Most commonly an incidental  finding & usually does not cause death. We report a case of an 85-year-old woman who came with history of road traffic accident, with  open right radius segmental shaft fracture for which debridement and K wire fixation was done but succumbed to complications. On post mortem and histo-pathological examination pulmonary bone fragment embolism was seen. Bone fragment embolism is most commonly  an incidental finding and it is usually overlooked when there is no major trauma involved. It is seen in cases with trauma to bones, bone  marrow transplantation, orthopaedic procedures and trauma to diseased bones. BFE is a tell-tale sign of past traumatic injury. In the  absence of other causes and even in the absence of a massive traumatic event, BFE should be kept in mind before issuing a cause of death.  

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References

Dettmer MS, Willi N, Thiesler T, Ochsner P, Cathomas G. The

impact of pulmonary bone component embolism: an autopsy

study. J Clin Pathol. 2014 Apr;67(4):370–4.

Jorens PG, Van Marck E, Snoeckx A, Parizel PM. Nonthrombotic pulmonary embolism. Eur Respir J. 2009 Aug;34(2):452–74.

Abrahams C, Catchatourian R. Bone fragment emboli in the lungs of patients undergoing bone marrow transplantation. Am J Clin Pathol. 1983 Mar;79(3):360–3.

Fernandez LA, Romaguera R, Viciana AL, Ruiz P, Tzakis AG, Ricordi C. Pulmonary embolism with bone fragments following vertebral body marrow infusion for tolerance induction. Cell Transplant. 1996 Aug;5(4):513–6.

Hara N, Minami T. Diffusive pulmonary embolism with bone fragments during spinal surgery. BJA: British Journal of Anaesthesia. 2006 Jul 1;97(1):119–20.

Bras J, Veraart B. Pulmonary bone embolism after total hip

volume. 1980 Mar 1;62-B:22–4.

Jenny-Möbius U, Bruder E, Stallmach T. Recognition and significance of pulmonary bone embolism. Int J Legal Med

;112(3):195–7.

Pape HC, Krettek C, Maschek H, Regel G, Tscherne H. Fatal pulmonary embolization after reaming of the femoral medullary cavity in sclerosing osteomyelitis: a case report. J Orthop Trauma. 1996;10(6):429–32.

Incze G, Arvay A. Traumatic bone embolism as vital reaction. Acta Morphol Acad Sci Hung. 1954;4(2):247–50.

absorbed and gets replaced by fibrous tissue. 9

Schinella RA. Bone marrow emboli. Their fate in the vasculature of the human lung. Arch Pathol. 1973

Jun;95(6):386–91.

Zichner L. [The importance of pulmonary embolism by bone fragments and bone marrow]. Langenbecks Arch Chir. 1970 Aug 31;326(4):367–79.

Published

2023-12-25

How to Cite

Bakkannavar , S. M., Jayakala , A., Nayak , D., Shetty , S., & Bhat , A. K. (2023). A Rare Case of Pulmonary Bone Fragment Embolism - A Case Report . Journal of Indian Academy of Forensic Medicine, 45(4), 417-418. https://doi.org/10.48165/jiafm.2023.45.4.26