Acute onset facial oedema. A complication of extubation

A case of sudden onset facial swelling which occurred in association with extubation is presented. Factors are suggested that may have made this patient--a known sufferer from chronic liver disease--more susceptible to the development of such a reaction, but the principle cause is thought to have been the changes in capillary hydrostatic pressure induced by the patient 'fighting' on the tracheal tube whilst regaining consciousness after an anaesthetic for the injection of her esophageal varices.