[Lung embolism caused by vaseline following insertion of a venous catheter]. / Lungenembolie mit Vaseline nach Legen eines Venenkatheters.

ABSTRACT

Pulmonary embolism usually is due to natural causes, most often to obstruction of pulmonary arteries by blood clots breaking loose from venous thrombi forming in the leg or pelvis. Clots of other cellular material such as tumor fragments or fatty tissue (this especially in case of severe soft tissue and skeletal trauma), but also foreign material can give rise to this- often times lethal-condition. This is a report of foreign-body pulmonary embolism with obstruction of mainly the right lower lobe pulmonary arteries due to white vaseline embolism, probably responsible for the patient's premature surmise. Clinical history, therapeutic measures and course of disease--including radiographic and laboratory findings are being presented. Autopsy revealed massive pulmonary embolism to the right lower lobe due to a whitish greasy substance, which was chemically identified to be white vaseline. Additionally, this zone of infarction also showed signs of severe pneumonia with abscess formation resembling that of necrotizing infarction and therefore felt to be related to the foreign body embolism. Histology showed evidence of pneumonia and also inflammatory changes of the pulmonary arteries in form of additional formation of endothelium with involvement of the internal elastic layer. Finally, several possible causes for this case of pulmonary vaseline embolism are being discussed. The exact mechanism remains unclear; but in view of the course of disease, some radiographic findings as well as those of autopsy and histology, it seems most likely that the vaseline embolism was connected to transjugular catheterization rather than to the two other mechanisms also described.