Philippe Camus, M.D.

Dijon, France

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VII.e

VII - Pulmonary vasculopathy

Fat/oil embolism - The FES embolism syndrome

Last update 17/06/2026

Migration of exogenous oil or lipids or endogenous fat into the distal pulmonary microcirculation can cause a syndrome of acute coughing, hypoxemia, pulmonary hypertension, pulmonary infiltrates and/or ARDS. Neurologic or visual impairment and obtundation characterizes those cases with transpulmonary shunting of oil/fat and have a guarded prognosis. Silicone embolism (see under VIm) is a closely-related syndrome. Iodinated oil embolism, a nearly specific complication of TACE is electron-dense on imaging (better visualized on non-enhanced CT). Imaging features: PMID 23102488. Review and pathology: PMID 29939780.

Causative drugs

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Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Amphotericin B (infusion)
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Anabolic androgenic steroids
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III.a
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Cardiopulmonary resuscitation (CPR)
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Cement (bone cement, kyphoplasty, vertebroplasty)
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Chemical abortion
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Corticosteroids, systemic (oral, parenteral)
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Excipients-Vehicle-Preservatives (of drugs)
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Excipients, erroneously/deliberately administered i.v.
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G/GM-CSF
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Lipids (parenteral)
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Lipiodol - Iodinated/iodized oil (RCM)
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Liposuction
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Lymphography
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Monooctanoin
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Oil - Paraffin - Lipids (i.v.)
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XVIII.h
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