Fat overload syndrome is a rare complication of intravenous fat emulsion therapy. It is due to infusion rate and/or dose of triglycerides lipid emulsion surpassing fat clearance capacity of the body. Several reports in the literature described fat overload syndrome which was caused by rapid infusion of lipid emulsions, all with soybean-based lipid emulsions. We describe one patient who received parenteral nutrition with 20% medium-chain and long-chain triglycerides lipid perioperatively for volvulus of sigmoid colon, followed by a precipitous drop in blood platelet suggestive of fat overload syndrome. After a complete withdrawal of medium-chain and long-chain triglycerides lipid emulsion, the platelet levels gradually returned to be normal.
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