Question:medium
A patient who is a known case of acute pancreatitis develops breathlessness and bilateral basal crepitations on day 4, with the chest radiograph shown below. What is the diagnosis?
A patient who is a known case of acute pancreatitis develops breathlessness and bilateral basal crepitations on day 4, with the chest radiograph shown below. What is the diagnosis?
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Pancreatitis plus day-4 hypoxia and bilateral diffuse opacities = non-cardiogenic lung injury.
Updated On: Jun 23, 2026
- Bilateral pneumonia
- ARDS
- Cardiogenic pulmonary embolism
- Collapse
Show Solution
The Correct Option is B
Solution and Explanation
Step 1: In a pancreatitis patient who turns breathless around day 4 with bibasal crackles and a film full of bilateral haziness, think acute respiratory distress syndrome.
Step 2: The mechanism is non-cardiogenic: cytokines released during severe pancreatitis injure the alveolar-capillary barrier, flooding alveoli with protein-rich fluid. The Berlin definition needs acute onset within a week, bilateral opacities not explained by effusion or collapse, hypoxaemia, and oedema not due to heart failure - all satisfied here.
Step 3: The alternatives fail on imaging or physiology. Pneumonia is patchy and infective, embolism rarely paints both lungs white diffusely, and lobar collapse shifts structures toward the dense side rather than producing symmetric infiltrates.
\[\boxed{\text{ARDS}}\]
Step 2: The mechanism is non-cardiogenic: cytokines released during severe pancreatitis injure the alveolar-capillary barrier, flooding alveoli with protein-rich fluid. The Berlin definition needs acute onset within a week, bilateral opacities not explained by effusion or collapse, hypoxaemia, and oedema not due to heart failure - all satisfied here.
Step 3: The alternatives fail on imaging or physiology. Pneumonia is patchy and infective, embolism rarely paints both lungs white diffusely, and lobar collapse shifts structures toward the dense side rather than producing symmetric infiltrates.
\[\boxed{\text{ARDS}}\]
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