EMBOLISM

EMBOLISM

  Embolism is the process of partial or complete obstruction of some part of the cardiovascular system by any mass carried in the circulation; the  transported intravascular mass detached from its site of origin is called an embolism.

  Emboli may be of various types-

A. Depending upon the matter in the emboli-

1. Solid - thromboemboli, tumour clumps, bacterial clumps, foreign bodies

2. Liquid - fat globules, amniotic fluid, bone marrow

3. Gaseous- air, other gases

B. Depend upon whether infected or non infected-

1. Blant, when sterile

2. Septic, when infected

C. Depending upon the source of the embli-

1. Cardiac emboli

2. Arterial emboli

3. Venous emboli

4. Lymphatic emboli

D. Depending upon the flow of blood:-

1. Paradoxical embolus:-

  An embolus which is carried from the venous side of circulation to the arterial side or vice versa is called paradoxical. Eg:- Through arteriovenous communication such as septum deffect.

2. Retrograte embolus:-

  An embolus which travel agains the flow of blood is called retrograte embolus.

Eg: During coughing or streaming

Fat embolism:-

  Obstruction of arterioles and capillary by fat globules constituents fat embolism. If the obstruction in the circulation is by fragments of adipose tissue is called fat tissue embolism.

Etiology:-

1. Traumatic cause-

  Trauma to bones - fracture of long bones leading to passage of fatty marrow in circulation.

2. Non-traumatic cause-

  Extensive burns, diabetes millitus, fatty liver, pancreatitis.

Consequences of fat embolism:-

  The effect of fat embolism depend upon the size and quantity of fat globule and whether or not the embolus pass through the lungs into the system circulation. 

i. Pulmonary fat embolism

ii. systemic fat embolism

Gas Embolism:-

  Air, nitrogen and other gases can produce bubbles with in the circulation and obstruct the blood vessels causing damage to tissue-

1. Air emblism:-

i. Venous air embolism:-

   Air may be sucked into the systemic veins under the following circumstances-

a. Operations on head and neck and trauma

b. Obstricted operation in trauma-

    During child birth by normal delivery, caesareal section and other procedure, fatal air embolism may result from the entrance of air into the opened up uterine venous sineses and metrial sineses or vein.

c. Intravenous infussion of blood and fluid

d. Angeography

ii. Arterial air embolism:-

  Entry of air into pulmonary vein in the following condition-

a. Cardiothoraxic surgery and trauma:-

    Arterial air embolism may occur following through thoraxic operation

Eg: Thoracocentestis,  rupture of lungs, penetrating moves of the lungs.

b. Paradoxical air embolism:-

    This may occur due to passage of venous air embolism to the arterial side to circulation through a pulmonary arteriovenous sunkes.