A 47-year-old man with acute pancreatitis develops acute respiratory distress two days after admission. He presents with dyspnea, hypoxemia (SpO2 78% on room air), and bilateral pulmonary infiltrates on chest X-ray. Vital signs: HR 118/min, RR 28/min, BP 132/88 mmHg, temperature 38.2°C. Pulmonary capillary wedge pressure is normal. Arterial blood gas shows PaO2 55 mmHg. He denies orthopnea. Which pathologic finding best explains these findings?
- A)Caseating granulomas in the upper lobes
- B)Diffuse alveolar damage with hyaline membranesGABARITO
- C)Mucus gland hyperplasia in large bronchi
- D)Noncaseating granulomas in the interstitium
- E)Subpleural bleb rupture with pleural air
Explicação
Diffuse alveolar damage with hyaline membranes is correct. Acute respiratory distress syndrome is caused by inflammatory injury to the alveolar capillary barrier, leading to protein rich edema, decreased compliance, and refractory hypoxemia. Sepsis, pancreatit... Ver explicação completa e trilha adaptativa →