Differential Diagnosis for Swollen Face and Body after Chest Tube Removal

• Single most likely diagnosis
  • Postoperative fluid overload or third spacing: This is a common issue after surgical procedures, including chest tube removal, where fluid can accumulate in the body due to various factors such as IV fluid administration, inflammation, or impaired lymphatic drainage.
• Other Likely diagnoses
  • Allergic reaction: An allergic reaction to medications, tape, or other substances used during the procedure could cause swelling.
  • Infection or sepsis: Although less common, an infection at the site of the chest tube or elsewhere in the body could lead to systemic inflammation and swelling.
  • Cardiac issues (e.g., heart failure): Pre-existing or newly developed cardiac problems could result in fluid accumulation and swelling.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Anaphylaxis: A severe, life-threatening allergic reaction that requires immediate intervention.
  • Pulmonary embolism: Although less directly related to swelling, a pulmonary embolism is a critical condition that could occur postoperatively and has a high mortality rate if not promptly treated.
  • Superior vena cava syndrome: Obstruction of the superior vena cava, which could be caused by a variety of factors including thrombosis or external compression, leading to facial and upper body swelling.
• Rare diagnoses
  • Lymphatic obstruction or damage: Direct injury to lymphatic vessels during the procedure could lead to localized or generalized swelling.
  • Angioedema: A rare condition characterized by the rapid swelling of the dermis, subcutaneous tissue, mucosa, and submucosal tissues, which can be life-threatening if it involves the airways.
  • Thyroid storm or myxedema: Although very rare and typically associated with specific thyroid conditions, these could present with swelling among other symptoms.