This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Surgery, Other  • Alert me on articles by topic

Shariq Sayeed, MD; Leonidas G. Koniaris, MD; Peter J. Papadakos, MD
From the Department of Surgery, University of Rochester Medical Center, Rochester, NY.

Arch Surg. 2002;137:491-492.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

A HEALTHY 42-YEAR-OLD farmer lost his balance while riding a tractor, which then ran over his chest and upper abdomen. A computed tomographic scan of the abdomen demonstrated a grade III liver laceration that was treated nonoperatively. However, during the next 12 hours, he developed progressive shortness of breath and required intubation. An arterial blood gas measurement gave the following results: pH, 7.31; PaO₂, 57; and PCO₂, 46, while the patient was receiving a fraction of inspired oxygen (FIO₂) of 80%. Chest x-ray films obtained at admission (A) and after intubation (B) are shown in Figure 1.

Figure 1.

What Is the Diagnosis?

A. Aspiration pneumonia

B. Cardiogenic pulmonary edema

C. Acute respiratory distress syndrome

D. Bilateral pneumonia

E. Acute lung injury

Answer: Acute Respiratory Distress Syndrome

Figure 1A, Chest radiograph shows a nondisplaced left clavicular fracture and mild increase in vascular markings. . . . [Full Text of this Article]