Following a subtotal gastrectomy, a patient develops fever early after surgery. The most likely cause is:

• A. Wound Infection
• B. Atelectasis
• C. Phlebitis
• D. Shock

Answer: (B)

After major abdominal surgery, fever in the first 24 to 48 hours is most often due to atelectasis from shallow breathing and splinting caused by pain. When the lungs don’t fully inflate, small areas collapse, which can trigger a mild fever as part of the early inflammatory response. This is a common, expected cause in the immediate postoperative period.

Wound infection typically appears later, usually after several days, with signs localized to the incision. Phlebitis would present with inflammation at a venous access site and possibly systemic signs, not the typical early postoperative fever pattern. Shock presents with low blood pressure and poor perfusion, not an isolated fever, especially so early after surgery. Pneumonia is possible but usually comes with cough, auscultatory findings, or purulent sputum and often develops as complications rather than immediately post-op.

So, the early fever most consistent with this scenario is atelectasis.