Differential Diagnosis for the Male Patient with Swelling in Front of the Ear

• Single Most Likely Diagnosis:
  • Infected Sebaceous Cyst: This is the most likely diagnosis given the description of a long-lasting swelling that is adherent to the skin, painful, and associated with redness. Sebaceous cysts can become infected, leading to these symptoms.
• Other Likely Diagnoses:
  • Parotid Abscess: Although less common, a parotid abscess could present with similar symptoms, including pain, redness, and swelling in front of the ear, especially if the infection involves the parotid gland.
  • Pleomorphic Adenoma: This is a common benign tumor of the salivary glands, which could cause a long-standing swelling. However, it is typically not painful or associated with redness unless it becomes infected.
• Do Not Miss Diagnoses:
  • Malignant Tumor: Although rare, a malignant tumor of the salivary gland or skin could present with similar symptoms. It is crucial not to miss this diagnosis due to its significant implications for treatment and prognosis.
• Rare Diagnoses:
  • Face Lipoma: Lipomas are benign tumors of fat tissue and are less likely to cause painful, red, and long-lasting swellings, especially in the specific location described.
  • Other Rare Salivary Gland Tumors or Conditions: There are several rare tumors and conditions of the salivary glands that could potentially cause these symptoms, but they are much less common than the diagnoses listed above.

Differential Diagnosis for the Post-Gastrectomy Patient

• Single Most Likely Diagnosis:
  • Jejunal Leakage: Given the elevated WBCs and the presence of drain output 3 days post-gastrectomy with Roux-en-Y gastrojejunostomy, a jejunal leakage is a plausible cause. This condition can lead to infection and inflammation, explaining the elevated white blood cell count.
• Other Likely Diagnoses:
  • Duodenal Stump Blowout: This is a serious complication that can occur after gastrectomy, where the duodenal stump leaks. It could explain the elevated WBCs but might also be associated with more significant clinical deterioration and possibly more drain output.
• Do Not Miss Diagnoses:
  • Oesophagojejunal Leak: Although less common, an oesophagojejunal leak is a serious complication that requires prompt diagnosis and treatment. It could present with similar symptoms, including elevated WBCs and possibly drain output.
• Rare Diagnoses:
  • Jejunojejunostomy Complications: While complications at the jejunojejunostomy site can occur, they are less likely to present with the specific combination of symptoms described, especially in the context of a normal NGT and soft, lax abdomen.