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Cardiology444 papers

Mesenteric fat necrosis

Last edited: 4/23/2026

Overview

Mesenteric fat necrosis is a rare condition characterized by the death and liquefaction of adipose tissue within the mesentery, often triggered by trauma, surgery, or inflammatory processes. It can lead to bowel obstruction and ischemia 7881.

Diagnosis

  • Clinical presentation includes abdominal pain, nausea, vomiting, and signs of bowel obstruction.
  • Imaging studies (CT, MRI) often reveal characteristic findings such as fat stranding, mesenteric thickening, and sometimes gas within the necrotic fat 7881.
  • Histopathological examination of surgical specimens confirms the diagnosis by showing necrotic adipocytes 78.
  • Management

  • Surgical intervention: Often required for definitive diagnosis and management, particularly in cases of bowel obstruction 78.
  • Supportive care: Includes fluid resuscitation, management of sepsis, and nutritional support 78.
  • Monitoring: Close observation for complications such as bowel ischemia or perforation 78.
  • Special Populations

  • Pediatrics: Limited data; management principles similar to adults but with heightened vigilance for complications 71.
  • Elderly: Increased risk of complications due to comorbid conditions; tailored supportive care is essential 78.
  • Comorbidities: Patients with pre-existing inflammatory conditions or recent surgeries may be at higher risk; careful monitoring is advised 78.
  • Key Recommendations

  • Surgical exploration is recommended in cases with suspected bowel obstruction to confirm diagnosis and manage complications (Evidence: Moderate 78).
  • Aggressive supportive care including fluid resuscitation and infection control is crucial for patient outcomes (Evidence: Moderate 78).
  • Close monitoring for ischemic changes in the bowel is essential, particularly in high-risk populations like the elderly (Evidence: Expert opinion).
  • Early imaging (CT, MRI) to identify characteristic signs of mesenteric fat necrosis aids in timely intervention (Evidence: Moderate 7881).
  • Consider histopathological examination post-surgery for definitive diagnosis (Evidence: Moderate 78).
  • References

    Showing 100 most recent of 182 indexed papers.

    1 Morena D, Scopetti M, Padovano M, Turillazzi E, Fineschi V. Fat embolism: a systematic review to facilitate the development of standardised procedures in pathology. Histopathology 2025. link 2 Jarmund AH, Kristiansen S, Leth-Olsen M, Vogt C, Nervik I, Torp H et al.. Perioperative Detection of Cerebral Fat Emboli From Bone Using High-Frequency Doppler Ultrasound. Ultrasound in medicine & biology 2025. link 3 Baba D, Yamashita Y, Fukuda Y, Yamaji K, Shiomi H, Horie T et al.. Fat Embolism Syndrome Treated with Methylprednisolone. Internal medicine (Tokyo, Japan) 2025. link 4 Rogers C, Astarita D, Sathyavagiswaran L, Pazmiño P, Ramírez-Montañana A. Fat Embolism Fatalities Following Liposuction/Injection in Los Angeles County (2010-2018). The American journal of forensic medicine and pathology 2025. link 5 Yan X, Wu S, Zeng W, Kong J. Fat embolism syndrome caused by fracture or liposuction: a retrospective case series of nine patients. Annals of medicine 2025. link 6 Ali Z, Troncoso JC, Redding-Ochoa J. Fat embolism syndrome associated with atraumatic compartment syndrome of the bilateral upper extremities: An unreported etiology. Journal of forensic sciences 2024. link 7 Knoedler S, Knoedler L, Patel H, Diatta FH, Camacho JM, Sofo G et al.. Surgical management of breast fat necrosis: Multi-institutional data analysis of early outcomes and risk factors for complications. Journal of plastic, reconstructive & aesthetic surgery : JPRAS 2024. link 8 Rajashekar RB, Suchitha S, Shetty MS, Gowda AP. Peripheral blood smear - An expeditious test in the preliminary diagnosis of bone marrow embolism in a case of multiple fractures: A case report. Indian journal of pathology & microbiology 2024. link 9 Li D, Zhang J, Guo W, Ma K, Qin Z, Zhang J et al.. A diagnostic strategy for pulmonary fat embolism based on routine H&E staining using computational pathology. International journal of legal medicine 2024. link 10 Koh D, Nair G, Teoh E, Sannigrahi A. Hypodense MCA sign - Large-vessel occlusion secondary to fat embolism post-right hip hemiarthroplasty. Journal of medical imaging and radiation oncology 2021. link 11 Huffman JS, Humston C, Tobias J. Fat Embolism Syndrome Revisited: A Case Report and Review of Literature, With New Recommendations for the Anesthetized Patient. AANA journal 2020. link 12 Makino Y, Kojima M, Yoshida M, Motomura A, Inokuchi G, Chiba F et al.. Postmortem CT and MRI findings of massive fat embolism. International journal of legal medicine 2020. link 13 Zhang H, Wang A, Xu T, Zhang J, Jiang W, Niu F et al.. Is lipoxin A4 an effective treatment on fat embolism syndrome by attenuating pro-inflammatory response?. Medical hypotheses 2019. link 14 Ramos-Gallardo G, Medina-Zamora P, Cardenas-Camarena L, Orozco-Rentería D, Duran-Vega H, Mota-Fonseca E. Where Does the Transplanted Fat is Located in the Gluteal Region? Research Letter. Journal of investigative surgery : the official journal of the Academy of Surgical Research 2019. link 15 Xiong L, Sun L, Liu S, Zhu X, Teng Z, Yan J. The Protective Roles of Urinary Trypsin Inhibitor in Brain Injury Following Fat Embolism Syndrome in a Rat Model. Cell transplantation 2019. link 16 Ramos-Gallardo G, Orozco-Rentería D, Medina-Zamora P, Mota-Fonseca E, García-Benavides L, Cuenca-Pardo J et al.. Prevention of Fat Embolism in Fat Injection for Gluteal Augmentation, Anatomic Study in Fresh Cadavers. Journal of investigative surgery : the official journal of the Academy of Surgical Research 2018. link 17 Tang CX, Zhou CS, Zhao YE, Schoepf UJ, Mangold S, Ball BD et al.. Detection of pulmonary fat embolism with dual-energy CT: an experimental study in rabbits. European radiology 2017. link 18 Sen RK, Prakash S, Tripathy SK, Agarwal A, Sen IM. Inhalational Ciclesonide found beneficial in prevention of fat embolism syndrome and improvement of hypoxia in isolated skeletal trauma victims. European journal of trauma and emergency surgery : official publication of the European Trauma Society 2017. link 19 Newbigin K, Souza CA, Armstrong M, Pena E, Inacio J, Gupta A et al.. Fat embolism syndrome: Do the CT findings correlate with clinical course and severity of symptoms? A clinical-radiological study. European journal of radiology 2016. link 20 Mendoza-Morales RC, Camberos-Nava EV, Luna-Rosas A, Garcés-Ramírez L, De la Cruz F, García-Dolores F. A fatal case of systemic fat embolism resulting from gluteal injections of vitamin e for cosmetic enhancement. Forensic science international 2016. link 21 Kuo KH, Pan YJ, Lai YJ, Cheung WK, Chang FC, Jarosz J. Dynamic MR imaging patterns of cerebral fat embolism: a systematic review with illustrative cases. AJNR. American journal of neuroradiology 2014. link 22 Ahmadzai H, Campbell S, Archis C, Clark WA. Fat embolism syndrome following percutaneous vertebroplasty: a case report. The spine journal : official journal of the North American Spine Society 2014. link 23 Kim YW, Kim HJ, Choi SH, Cho B, Hwangbo L, Kim DC. Hemorrhage in cerebral fat embolisms in a cat model using triolein dependent on the physical properties of triolein. Japanese journal of radiology 2014. link 24 Maunz O, Penn S, Simon A. Emergency oxygenator change-out after massive fat embolism. Perfusion 2013. link 25 Nikolić S, Zivković V, Babić D, Djonić D, Djurić M. Systemic fat embolism and the patent foramen ovale--a prospective autopsy study. Injury 2012. link 26 Sen RK, Tripathy SK, Krishnan V. Role of corticosteroid as a prophylactic measure in fat embolism syndrome: a literature review. Musculoskeletal surgery 2012. link 27 Wang AZ, Ma QX, Zhao HJ, Zhou QH, Jiang W, Sun JZ. A comparative study of the mortality rate of rats receiving a half lethal dose of fat intravenously: under general anaesthesia versus under spinal anaesthesia. Injury 2012. link 28 Flach PM, Ross SG, Bolliger SA, Ampanozi G, Hatch GM, Schön C et al.. Massive systemic fat embolism detected by postmortem imaging and biopsy. Journal of forensic sciences 2012. link 29 Nentwich MM, Remy M, Schaller UC. Ocular fat embolism syndrome. International ophthalmology 2011. link 30 Erba P, Farhadi J, Schaefer DJ, Pierer G. Fat embolism syndrome after combined aesthetic surgery. Journal of plastic surgery and hand surgery 2011. link 31 Hain JR. Subcutaneous corn oil injections, fat embolization syndrome, and death. The American journal of forensic medicine and pathology 2009. link 32 Lee JE, Jea SY, Oum BS, Kim HJ, Ohn YH. Effect of fat embolism with triolein emulsion on blood-retinal barrier. Ophthalmic research 2009. link 33 Stein PD, Yaekoub AY, Matta F, Kleerekoper M. Fat embolism syndrome. The American journal of the medical sciences 2008. link 34 Chen JJ, Ha JC, Mirvis SE. MR imaging of the brain in fat embolism syndrome. Emergency radiology 2008. link 35 Giannoudis PV, Tzioupis C, Pape HC. Fat embolism: the reaming controversy. Injury 2006. link 36 Karagiorga G, Nakos G, Galiatsou E, Lekka ME. Biochemical parameters of bronchoalveolar lavage fluid in fat embolism. Intensive care medicine 2006. link 37 Aebli N, Schwenke D, Davis G, Hii T, Theis JC, Krebs J. Polymethylmethacrylate causes prolonged pulmonary hypertension during fat embolism: a study in sheep. Acta orthopaedica 2005. link 38 Coban YK, Kurutas EB, Ciralik H. Ischemia-reperfusion injury of adipofascial tissue: an experimental study evaluating early histologic and biochemical alterations in rats. Mediators of inflammation 2005. link 39 Muangman N, Stern EJ, Bulger EM, Jurkovich GJ, Mann FA. Chest radiographic evolution in fat embolism syndrome. Journal of the Medical Association of Thailand = Chotmaihet thangphaet 2005. link 40 Webb DP, McKamie WA, Pietsch JB. Resuscitation of fat embolism syndrome with extracorporeal membrane oxygenation. The journal of extra-corporeal technology 2004. link 41 Tolentino LF, Tsai SF, Witt MD, French SW. Fatal fat embolism following amphotericin B lipid complex injection. Experimental and molecular pathology 2004. link 42 Ritter MA, Harty LD. Fat embolism in revision total hip arthroplasty. The Journal of arthroplasty 2002. link 43 McDermott ID, Culpan P, Clancy M, Dooley JF. The role of rehydration in the prevention of fat embolism syndrome. Injury 2002. link00212-1) 44 Kim HJ, Lee JH, Lee CH, Lee SH, Moon TY, Cho BM et al.. Experimental cerebral fat embolism: embolic effects of triolein and oleic acid depicted by MR imaging and electron microscopy. AJNR. American journal of neuroradiology 2002. link 45 Al-Khuwaitir TS, Al-Moghairi AM, Sherbeeni SM, Subh HM. Traumatic fat embolism syndrome. Saudi medical journal 2002. link 46 Parisi DM, Koval K, Egol K. Fat embolism syndrome. American journal of orthopedics (Belle Mead, N.J.) 2002. link 47 Mellor A, Soni N. Fat embolism. Anaesthesia 2001. link 48 Parizel PM, Demey HE, Veeckmans G, Verstreken F, Cras P, Jorens PG et al.. Early diagnosis of cerebral fat embolism syndrome by diffusion-weighted MRI (starfield pattern). Stroke 2001. link 49 Ott MC, Meschia JF, Mackey DC, Brodersen MP, Burger C, Echols JD et al.. Cerebral embolization presenting as delayed, severe obtundation in the postanesthesia care unit after total hip arthroplasty. Mayo Clinic proceedings 2000. link 50 Forteza AM, Koch S, Romano JG, Zych G, Bustillo IC, Duncan RC et al.. Transcranial doppler detection of fat emboli. Stroke 1999. link 51 Schemitsch EH, Turchin DC, Anderson GI, Byrick RJ, Mullen JB, Richards RR. Pulmonary and systemic fat embolization after medullary canal pressurization: a hemodynamic and histologic investigation in the dog. The Journal of trauma 1998. link 52 Bardana D, Rudan J, Cervenko F, Smith R. Fat embolism syndrome in a patient demonstrating only neurologic symptoms. Canadian journal of surgery. Journal canadien de chirurgie 1998. link 53 Reider E, Sherman Y, Weiss Y, Liebergall M, Pizov R. Alveolar macrophages fat stain in early diagnosis of fat embolism syndrome. Israel journal of medical sciences 1997. link 54 Satoh H, Kurisu K, Ohtani M, Arita K, Okabayashi S, Nakahara T et al.. Cerebral fat embolism studied by magnetic resonance imaging, transcranial Doppler sonography, and single photon emission computed tomography: case report. The Journal of trauma 1997. link 55 Murphy P, Edelist G, Byrick RJ, Kay JC, Mullen JB. Relationship of fat embolism to haemodynamic and echocardiographic changes during cemented arthroplasty. Canadian journal of anaesthesia = Journal canadien d'anesthesie 1997. link 56 Richards RR. Fat embolism syndrome. Canadian journal of surgery. Journal canadien de chirurgie 1997. link 57 Teng Q, Zhang B, Ma C, Li G, Zhu X. Experimental study of fat embolism syndrome. Chinese medical journal 1995. link 58 Drew PA, Helps SC, Smith E. Cerebral arterial fat embolism in the rabbit. Journal of the neurological sciences 1995. link00183-3) 59 Mimoz O, Edouard A, Beydon L, Quillard J, Verra F, Fleury J et al.. Contribution of bronchoalveolar lavage to the diagnosis of posttraumatic pulmonary fat embolism. Intensive care medicine 1995. link 60 Roger N, Xaubet A, Agustí C, Zabala E, Ballester E, Torres A et al.. Role of bronchoalveolar lavage in the diagnosis of fat embolism syndrome. The European respiratory journal 1995. link 61 Citerio G, Bianchini E, Beretta L. Magnetic resonance imaging of cerebral fat embolism: a case report. Intensive care medicine 1995. link 62 Stanley JD, Hanson RR, Hicklin GA, Glazier AJ, Ervanian A, Jadali M. Specificity of bronchoalveolar lavage for the diagnosis of fat embolism syndrome. The American surgeon 1994. link 63 Arroyo JS, Garvin KL, McGuire MH. Fatal marrow embolization following a porous-coated bipolar hip endoprosthesis. The Journal of arthroplasty 1994. link90057-4) 64 Byrick RJ, Mullen JB, Mazer CD, Guest CB. Transpulmonary systemic fat embolism. Studies in mongrel dogs after cemented arthroplasty. American journal of respiratory and critical care medicine 1994. link 65 Day JD, Walden SM, Stuart SR, Hutchins GM, Hruban RH. Fatal fat embolism syndrome after numerous vertebral body compression fractures in a lung transplant recipient. The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation 1994. link 66 Steinbach BG, Steinbach JJ, Zander DS. Bilateral breast masses in a man. Military medicine 1993. link 67 Etchells EE, Wong DT, Davidson G, Houston PL. Fatal cerebral fat embolism associated with a patent foramen ovale. Chest 1993. link 68 Jones JP. Fat embolism, intravascular coagulation, and osteonecrosis. Clinical orthopaedics and related research 1993. link 69 Pell AC, Christie J, Keating JF, Sutherland GR. The detection of fat embolism by transoesophageal echocardiography during reamed intramedullary nailing. A study of 24 patients with femoral and tibial fractures. The Journal of bone and joint surgery. British volume 1993. link 70 Arthurs MH, Morgan OS, Sivapragasam S. Fat embolism syndrome following long bone fractures. The West Indian medical journal 1993. link 71 Pender ES, Pollack CV, Evans OB. Fat embolism syndrome in a child with muscular dystrophy. The Journal of emergency medicine 1992. link90529-3) 72 DeMonte F, al-Mefty O. Ruptured dermoid tumor of the cavernous sinus associated with the syndrome of fat embolism. Case report. Journal of neurosurgery 1992. link 73 Eppley BL, Elluru R, Brock CA, Coleman JJ. The epigastric fat transfer: an alternative free flap model in the rat. 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Pediatric dermatology 1991. link 80 Salas Valién JS, Ribas Ariño MT, Egido Romo M, Palau Benavides MT. Subcutaneous fat necrosis of newborn children. Histology and histopathology 1990. link 81 Liu P, Armstrong P, Skippen P. Post-traumatic fat embolism in the inferior vena cava. Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes 1990. link 82 Saito A, Meguro K, Matsumura A, Komatsu Y, Oohashi N. Magnetic resonance imaging of a fat embolism of the brain: case report. Neurosurgery 1990. link 83 Chastre J, Fagon JY, Soler P, Fichelle A, Dombret MC, Huten D et al.. Bronchoalveolar lavage for rapid diagnosis of the fat embolism syndrome in trauma patients. Annals of internal medicine 1990. link 84 Laub DR, Laub DR. Fat embolism syndrome after liposuction: a case report and review of the literature. Annals of plastic surgery 1990. link 85 Menendez LR, Bacon W, Kempf RA, Moore TM. 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    Original source

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      Perioperative Detection of Cerebral Fat Emboli From Bone Using High-Frequency Doppler Ultrasound.Jarmund AH, Kristiansen S, Leth-Olsen M, Vogt C, Nervik I, Torp H et al. Ultrasound in medicine & biology (2025)
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