BACKGROUND:Acute respiratory distress occurring in a child without any past medical history can have different origins. Pulmonary edema can be lesional or hemodynamic in origin. Bronchoalveolar lavage often allows indication of the type of lesional oedema.

CASE REPORT:A 13-year 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 secondary 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 macrophages.

CONCLUSION:Fat embolism syndrome may be confirmed by examination of bronchoalveolar lavage fluid.

译文

背景:在没有任何既往病史的儿童中发生的急性呼吸窘迫可能有不同的起源。肺水肿的起源可能是病变或血流动力学。

病例报告:一名13岁的儿童在膝盖手术后并发骨折的24小时内因急性呼吸窘迫住院。胫骨干physi端。没有气道阻塞的临床表现。胸部X线表现为肺实质病理。多普勒超声心动图消除了充血性心力衰竭继发的肺水肿。支气管肺泡灌洗发现病灶性肺水肿的原因是许多肺泡巨噬细胞的细胞质中出现脂肪滴。

结论:通过检查支气管肺泡灌洗液可以确定脂肪栓塞综合征。

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