A patient who underwent an abdominal hysterectomy develops pleuritic chest pain and dyspnea. What is the most likely diagnosis?

When considering a patient who has recently undergone an abdominal hysterectomy and develops pleuritic chest pain and dyspnea, the most likely diagnosis is pulmonary embolism. Following surgical procedures, particularly those involving the abdomen or pelvis, patients are at an increased risk of venous thromboembolism due to factors such as immobility, surgical trauma, and the hypercoagulable state that can occur post-operatively.

Pulmonary embolism occurs when a thrombosis, often originating from the deep veins of the legs, travels to the pulmonary arteries, resulting in symptoms such as sudden onset of dyspnea (shortness of breath) and pleuritic chest pain, which is sharp and exacerbated by breathing or coughing. The timing of the symptoms in relation to the surgery further supports this diagnosis, as the risk for venous thromboembolism is heightened shortly after surgery.

While atelectasis, pneumothorax, and myocardial infarction are all important considerations in postoperative patients with respiratory symptoms, they are less likely to align with the specific combination of pleuritic chest pain and dyspnea seen in this scenario. Atelectasis typically presents more insidiously, often with decreased breath sounds on examination, and is commonly associated with