Lung fat embolism in a body changed by putrefaction: a hip fracture antemortem in origin

Fat embolism in the lungs can unreservedly be accepted as a vital reaction even in cases of advanced putrefaction. A case is presented herein of an 80-year-old woman, found dead in her locked flat, lying on her right side on the floor. In addition to hip fracture, an external examination of the body and a forensic autopsy revealed putrefactive changes. The histological examination of frozen Sudan III-stained sections of the lungs was performed, where orange, drop, sausage- and branching-shaped fat emboli were found. Despite advanced postmortem putrefaction changes, findings of fat emboli in the lung vessels demonstrated that the hip fracture was antemortem in origin. In this case study, the utility of a lung fat embolism is highlighted as being a vital sign even in cases where the body of the deceased has been changed by advanced putrefaction.