ACUTE RESPIRATORY-DISTRESS SYNDROME DUE T O FAT-EMBOLISM

Background. - Acute respiratory distress ocurring in a child without a ny past medical history can have different origins. Pulmonary edema ca n be lesional or hemodynamic in origin. Bronchoalveolar lavage often a llows indication of the type of lesional oedema. Case report. - A 13-y ear old child was hospitalized for acute respiratory distress 24 hours after knee surgery complicated by a fracture of the tibial metaphysis . There were no clinical manifestations of airway obstruction. Chest X -ray showed pulmonary parenchymous pathology. Pulmonary edema secondar y to congestive heart failure was eliminated by doppler echocardiogram . The cause of lesional pulmonary edema was found with bronchoalveolar lavage that showed fat drops in the cytoplasm of many alveolar macrop hages. Conclusion. - Fat embolism syndrome may be confirmed by examina tion of bronchoalveolar lavage fluid.