Learning objectives
To describe the chest x ray signs in patients with a clinical picture compatible with pulmonary embolism due to silicone.
To describe the tomographic findings in patients with pulmonary embolism due to silicone.
Discuss representative cases of silicone pulmonary embolism.
Background
Liquid silicone (polydimethylsiloxane) is a highly stable synthetic polymer,
which has poor immunogenicity,
minimal tissue reaction,
few changes in physical characteristics with temperature and age,
and is not carcinogenic,
commonly used for medical and cosmetic purposes,
the latter associated with serious complications.
Common sites of illicit subcutaneous injection of silicone that have been reported are the breasts,
the trochanteric region,
and the buttocks [1].
Complications associated with illicit injection occur with an incidence rate of up to 1-2%,
[1] including local effects such as tissue...
Findings and procedure details
We describe 4 patients with an average age of 33 years at the time of presentation of symptoms.
Three of the patients were women and one male patient.
In all cases,
the injection site was the buttocks.
The average time between the last injection and the onset of symptoms was 90 hours.
All patients presented with dyspnea and developed respiratory failure with the need for invasive mechanical ventilation.
The outcome of one of the patients is unknown since he was transferred from the institution; of...
Conclusion
Silicone pulmonary embolism is a serious complication of the illicit injection of liquid silicone,
with high mortality rates.
The series of cases described here presented a pattern of peripheral ground-glass opacities with septal thickening and in some cases airspace consolidation,
without evidence of pleural fluid.
It is important to note that the radiologist can play an important role in the early recognition of the typical imaging pattern of this pathology,
having a potential impact on the patient’s outcome.
References
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