Acute pulmonary edema following surgery

This patient became acutely short of breath following surgery. Why is this an emergency? The patient has:

• a. Left lower lobe pneumonia.
• b. Acute pulmonary edema.
• c. A large pneumothorax.
• d. A large pericardial effusion.
• e. A ruptured gastric ulcer.

Correct Answer: Acute pulmonary edema.

Explanation

There is diffuse airspace disease in both lungs causing almost complete opacification of both lungs. This came on suddenly and is characteristic of pulmonary edema. Other fluids can inhabit the airspaces such as blood or gastric aspirate, but they have different clinical stories and are less common than acute pulmonary edema. This patient had been hypotensive and was suffering from non-cardiogenic pulmonary edema. Vasopressors and diuretics were used in his treatment.

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