Presentation
Recurrent painful swelling of the left parotid gland, without fever.
Patient Data
The gland is enlarged, and the gland parenchyma is slightly hypoechoic. The parenchyma is heterogeneous and appears like a “leopard-skin”. Multiple hypoechoic or anechoic spots with a polycystic-like aspect are visible due to peripheral duct ectasia. Hyperechoic reflexes can be observed within the sialectatic ducts, possibly corresponding to air, and increased intraparotid lymph nodes.
The contralateral parotid gland has a normal appearance.
Case Discussion
This patient underwent a sialoendoscopy, with mucus plugs of the parotid duct and a whitish ductal mucosa expressing inflammation along with symptomatic treatment of antibiotics, analgesics, warm compresses, and sialagogues.
Inflammation of the salivary glands is caused by obstructive pathologies of the duct, such as stones and stenosis, and symptoms are due to saliva stasis and secondary infection. Ultrasound is useful in detecting parenchymal changes, such as atelectasis and morphological changes in the parotid duct. Recurrent episodes of unilateral or bilateral painful parotid edema are possible. Sialendoscopy is a diagnostic and therapeutic procedure for treating juvenile recurrent parotitis.
Radiographer: TSRM Nunzio BiancoTreatment.
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