Rapid orbital lipolysis associated with critical illness and colectomy

Joy Li; Aikta Rajput; David Kosoy; Sari Umekawa; Anuj Rajput; Jessica Chang; Vishal Patel

doi:10.1016/j.radcr.2021.06.001

Rapid orbital lipolysis associated with critical illness and colectomy

Radiol Case Rep. 2021 Jul 1;16(9):2347-2350. doi: 10.1016/j.radcr.2021.06.001. eCollection 2021 Sep.

Authors

Joy Li¹, Aikta Rajput², David Kosoy², Sari Umekawa³, Anuj Rajput⁴, Jessica Chang⁵, Vishal Patel⁶

Affiliations

¹ University of Southern California, Keck School of Medicine, Los Angeles, CA, USA.
² St. George's University, University Centre, Grenada.
³ The Queen's Medical Center, Department of Pulmonary Critical Care, Honolulu, HI, USA.
⁴ Los Angeles Imaging and Interventional Consultants at PIH Health, Department of Radiology, Whittier, CA, USA.
⁵ University of Southern California, Keck School of Medicine, Department of Ophthalmology, Los Angeles, CA, USA.
⁶ University of Southern California, Keck School of Medicine, Department of Radiology, Los Angeles, CA, USA.

Abstract

Orbital lipolysis typically develops in the setting of a chronic catabolic state. The acute development and rapid progression of orbital lipolysis are much less commonly described. In this report, we present a rare case of a 64-year-old male who progressed from normal orbital fat content to marked orbital lipolysis in less than one month following episodes of undifferentiated shock, colonic perforation, and total colectomy. We outline the clinical course, describe the characteristic imaging findings, and provide a review of the cellular mechanisms underlying lipolysis. Our case suggests that multiple concurrent illnesses can combine to produce an extreme metabolic demand that may contribute to the uncommon development of rapidly-progressing orbital lipolysis.

Keywords: Cachexia; Catabolism; Enophthalmos; Orbital lipolysis.

Publication types

Case Reports