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[Clinical Picture] Cerebral fat embolism after bone fractures

After a forklift accident, a 44-year-old man was admitted to our hospital in July, 2014, with fractures of the right fibula and tibia, the left femur, and the pelvis. A proximal femoral nail antirotation was done to stabilise the left femur. 1 h after the operation, he developed acute respiratory failure, requiring reintubation and admission to the intensive-care unit. CT angiography of the thorax showed bilateral ground-glass opacities and distinct nodular opacities (figure), without pulmonary embolism or aspiration.