Had Mediastinal Tumor Removed. Had Chest Tube Placed. Noticed Swelling Under The Rib Cage. Remedy?

Posted on Sun, 25 Aug 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 25 Aug 2013 Answered on

Fri, 13 Sep 2013 Last reviewed on

Question : i am 46, female, slightly over weight, non- smoker. I recently had a mediastinal tumor removed. i had a chest tube placed on my right side. its almost 3 months post surgery and Ive noticed that under my rib cage there seems to be some swelling. It is getting larger. about a month ago i had a CT scan and ultrasound of that particular area done. My surgeon suspected fluid. But all the tests came back negative yet I am concerned. I get occasional sharp pain in that area. this worries me. Is there another test I can ask about? Its disheartening when my GP and surgeon both say they have no idea what is is.

Answered by Dr. Hari Charan Perigela (35 minutes later)

Brief Answer:
It could be soft tissue edema.

Detailed Answer:
Hi
Normally chest tube will be removed once it is confirmed that there is no fluid in the pleural cavity,i.e,space surrounding lungs.
Eventhough fluid is collected in the pleura,it causes pain and difficulty in breathing,but not as collection below ribcage.If at all fluid is present,it will be confirmed by ultrasound and CT.
As fluid is not there,it could be soft tissue edema or air that has leaked into the layers (subcutaneous emphysema)beneath the skin below ribcage.both will subside gradually.
If there is infection,there will be pain and redness.
The bestway to confirm it is to put a widebore needle into the swelling and aspirate.The content will give a clue.Insist your doctor to do this under local anaesthesia.
If nothing is aspirated,it could be simple soft tissue swelling or air inside.
If you have any queries, i will clarify further
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hari Charan Perigela (8 hours later)

I understand about possible trapped air, but shouldn't it start to subside 3 months after surgery? The swelling has grown and doubled in size. What about the sharp pain?

Answered by Dr. Hari Charan Perigela (17 minutes later)

Brief Answer:
Pain is due to the swelling

Detailed Answer:
Hi
Air will be absorbed within few days,does not require 3 months.
If the swelling is in a tight area,there will be sharp pain.
Just aspirate with a wide bore needle.
The content will be confirmed.
Wish you good health
Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar