Presentation
Bilateral painless swelling of the submandibular glands 12 hours after receiving intravenous iodinated contrast for an abdominal CT scan.
Patient Data
Bilateral enlargement of the submandibular glands, which show indistinct margins and intense contrast enhancement. Periglandular fat stranding and thickening of the deep cervical fascia. Findings compatible with acute sialadenitis.
An increase in the number of periglandular lymph nodes can also be observed.
However, dilatation of the duct due to sialolithiasis is not observed.
A follow-up ultrasound performed 2 weeks later shows normal submandibular glands.
Case Discussion
Contrast-induced sialadenitis is a rare, self-limiting adverse reaction consisting of rapid, painless enlargement of the salivary glands (“iodide mumps”) shortly after infusion of iodinated contrast medium 1.
The patient presented to the emergency department with gastrointestinal bleeding. An abdominopelvic CT scan with contrast was performed, revealing no abnormalities. Twelve hours later, the patient developed painful, bilateral enlargement of the submandibular glands, prompting a contrast-enhanced neck CT.
The differential diagnosis for bilateral non-lithiasis sialadenitis includes viral or rheumatologic causes; however, due to the clear temporal relationship with the administration of iodinated contrast, the latter was concluded. The patient received symptomatic treatment, and the symptoms resolved within 24 hours. Although contrast-induced sialadenitis is associated with renal dysfunction 2, the patient had normal renal function.
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