Differential Diagnosis for Dialysis Port Bulging

• Single most likely diagnosis
  • Infection or abscess formation: This is a common complication of dialysis ports, and bulging can be a sign of accumulation of pus or infected fluid around the port.
• Other Likely diagnoses
  • Hematoma: Bleeding into the tissue around the port can cause it to bulge, especially if there has been recent access or manipulation of the port.
  • Seroma: Fluid accumulation around the port, not due to infection, can also cause bulging.
  • Catheter malfunction or kinking: Issues with the catheter itself can lead to improper dialysis and fluid buildup, potentially causing the port to bulge.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Septicemia or bacteremia: Infection of the port can lead to systemic infection, which is life-threatening and requires immediate attention.
  • Air embolism: Although rare, introduction of air into the vascular system through the dialysis port can be fatal and must be considered in cases of sudden port bulging or patient instability.
• Rare diagnoses
  • Tumor or cyst formation: Rarely, a bulging dialysis port could be due to the formation of a tumor or cyst in the vicinity of the port, although this would be an uncommon cause.
  • Vascular aneurysm or pseudoaneurysm: These are abnormal dilations of blood vessels that could potentially cause bulging near the site of the dialysis port, especially if related to the vascular access used for dialysis.