A 62-Year-Old Man Undergoes a Partial Pancreatectomy for Exocrine Pancreatic

A 62-year-old man undergoes a partial pancreatectomy for exocrine pancreatic cancer.  The surgery is complicated by excessive peripancreatic bleeding requiring careful surgical hemostasis.  The patient receives packed red blood cell transfusion during the surgery as well as intravenous normal saline.  He is transferred to the surgical intensive care unit for close monitoring and is successfully extubated.  Twelve hours later, the nurse reports decreased oxygen saturation.  The patient has received multiple doses of morphine for pain control since the surgery.  Temperature is 37.5 C (99.5 F) , blood pressure is 80/40 mm Hg, pulse is 112/min, and respirations are 28/min.  The patient's pulse oximetry shows 87% on 4 L nasal cannula oxygen.  Examination reveals bilateral basal crackles.  The abdomen is mildly distended and tender, and bowel sounds are decreased.  There is no rebound tenderness or rigidity.  Pulmonary artery catheter readings show a cardiac index of 2 L/min/m² (normal, 2.8-4.2) and a pulmonary capillary wedge pressure of 20 mm Hg (normal, 6-15) .  Which of the following is the most likely etiology of this patient's current condition?

A) Acute pancreatitis
B) Adrenal crisis
C) Myocardial infarction
D) Pulmonary embolism
E) Retroperitoneal hemorrhage
F) Transfusion-related acute lung injury

Correct Answer:

Verified

Unlock this answer now
Get Access to more Verified Answers free of charge

Access For Free