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| IMAGE OF INTEREST |
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| Year : 2021 | Volume
: 1
| Issue : 4 | Page : 174 |
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Postendoscopy bilateral parotid enlargement
Kartik Natarajan1, Kushan Sengupta1, VS Hemamala2, Ubal Dhus1
1 Department of Gastroenterology, Apollo Hospitals, Chennai, Tamil Nadu, India
2 Department of Gastroenterology, MIOT Hospitals, Chennai, Tamil Nadu, India
| Date of Submission | 20-Jun-2021 |
| Date of Acceptance | 12-Aug-2021 |
| Date of Web Publication | 24-Sep-2021 |
Correspondence Address:
Kartik Natarajan
Flat Number 6, Second Floor, Gopalakunj, Srinivasa Pillai Street, West Mambalam, Chennai - 600 033, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ghep.ghep_32_21
How to cite this article:
Natarajan K, Sengupta K, Hemamala V S, Dhus U. Postendoscopy bilateral parotid enlargement. Gastroenterol Hepatol Endosc Pract 2021;1:174 |
A 51-year-old female diagnosed to have compensated chronic liver disease underwent endoscopy to assess variceal status. Endoscopy was unremarkable and uneventful. Thirty minutes postprocedure, she developed painless bilateral swelling over the parotid regions [Figure 1]. On palpation, there were no warmth, tenderness, crepitus, or signs of subcutaneous emphysema over the neck and chest. Bilateral parotid enlargement was confirmed by ultrasound. The patient was managed conservatively. She was allowed liquids 3 h after the procedure. The swelling spontaneously decreased in size by almost 30% after 2 h. The next morning, the patient was comfortable with complete regression of the swelling. Postendoscopy parotid enlargement is a transient complication that usually subsides within 24 h. The mechanisms postulated for postendoscopy transient parotitis are blockage of the salivary ducts by secretions, venous congestion caused by straining or coughing during the procedure,[1] the use of anticholinergic drugs or neuromuscular blockers, and reflex parasympathetic stimulation during the procedure leading to vasodilation in the parotid gland.[2] Head manipulations and prolonged duration of endoscopy are considered risk factors for the condition.[3] If the swelling does not resolve rapidly, further evaluation is suggested.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that names and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | |  |
| 1. | Matsuki A, Wakayama S, Oyama T. Acute transient swelling of the salivary glands during and following endotracheal anaesthesia. Anaesthesist 1975;24:125-8.  |
| 2. | Strowbridge NF. Acute salivary gland enlargement following instrumentation of the upper airway. J R Army Med Corps 1987;133:163-5. |
| 3. | Adachi Y, Suzuki K, Itagaki T, Obata Y, Doi M, Sato S. Two cases of anesthesia mumps in the upper parotid gland after general anesthesia in the lateral position. Masui 2008;57:1150-2. |
[Figure 1]
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