Abstract
Upper gastrointestinal (UGI) endoscopy is a routine procedure done in field of gastroenterology. It is a safe procedure which can be done with or without sedation with rare post procedure complications. Our case illustrates that parotid gland swelling is a uncommon event post upper g.i endoscopy and it a benign event which resolves on its own.
Keywords: UGI, O.P.D, G.A
Introduction
Routine upper gastrointestinal endoscopy (UGIE) is an outpatient department (OPD) procedure and mostly uneventful. Sometimes certain benign events occur even in routine endoscopy, and the awareness of such events is important to avoid panic.
Case Report
We present a case of 42-year-old male patient who underwent UGIE for dyspepsia. The UGIE was normal, however, after endoscopy patient complains of swelling of his cheek and neck. On examination, there was swelling of right parotid gland, but there was no crepitus in the neck [Figure 1]. After 4 h the swelling subsided on its own.
Figure 1.
Figure showing parotid gland swelling post-upper GI endoscopy
Discussion
The swelling of the salivary glands after general anesthesia, bronchoscopy, or UGIE is a rare event.[1,2] Couper reported that manipulation of head during endoscopy may lead to obstruction of thoracic inlet venous drainage with subsequent congestion of parotid gland.[3] The usually involved glands are the parotid and the submaxillary glands. Although the etiology is unclear, several mechanisms have been proposed. These transitory swellings seem to be related to retention of secretions causing a blockage of the salivary ducts.[4,5] Coughing and straining could produce slight swelling and may lead to venous congestion of the salivary glands.[6] Dehydration may result in thick secretions and predispose to salivary duct occlusion. Parasympathetic stimulation during esophageal intubation, resulting in parotid vasodilation, and enlargement, has also been implicated.[5]
Blackford (1944) and Bonchek felt that a reflex arc with afferent stimuli arising in the mouth or pharynx and an abnormally intense efferent response mediated through the facial or glossopharyngeal nerves led to vasodilatation and swelling of salivary glands.[7,8]
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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