Differential Diagnosis for 78 YOF with Swelling on Left Arm and Neck
Single Most Likely Diagnosis
- Deep Vein Thrombosis (DVT) with Pulmonary Embolism (PE) related complications or Superior Vena Cava (SVC) syndrome: The recent lung surgery is a significant risk factor for DVT and PE. The swelling on the left arm and neck could be related to these complications, especially if the DVT or PE has led to SVC syndrome, which can cause swelling in the upper body due to obstruction of the superior vena cava.
Other Likely Diagnoses
- Lymphedema: Post-surgical lymphedema can occur, especially if lymph nodes were removed or damaged during the lung surgery. This could lead to swelling in the arm and potentially the neck.
- Seroma or Hematoma: Fluid accumulation at the surgical site can cause swelling and may have tracked up to the neck, potentially causing the observed symptoms.
- Infection: Post-surgical infection can cause swelling, redness, and warmth, and the crepitus could indicate gas in the tissues, suggesting a gas-producing organism.
Do Not Miss Diagnoses
- Necrotizing Fasciitis: Although rare, this is a life-threatening infection that can cause swelling, pain, and crepitus due to gas production. It requires immediate surgical intervention.
- Pulmonary Embolism with associated complications: A large PE can cause obstruction of major vessels, leading to swelling and potentially life-threatening complications.
- Sepsis: Post-surgical sepsis can present with swelling, fever, and other systemic signs, and is critical to identify and treat promptly.
Rare Diagnoses
- Thoracic Duct Injury: This could lead to chylothorax or chylous leak, causing swelling due to the accumulation of lymphatic fluid. It's a rare but possible complication of thoracic surgery.
- Venous Thoracic Outlet Syndrome: Compression of the subclavian vein can cause swelling in the arm and potentially the neck, though this would be less likely in the immediate post-surgical period without specific risk factors.