Abstract
We encountered a 59-year-old man who first underwent left internal carotid endarterectomy for left internal carotid artery stenosis and then presented with postoperative swelling of the bilateral salivary glands. He then developed upper airway obstruction that required emergency tracheal intubation. The most likely cause was thought to be anesthesia mumps, which involves a complex interaction of multiple factors including pneumoparotitis, venous congestion, and excess saliva secretion. Many cases of salivary gland swelling recover after follow-up observation alone if there are no inflammatory findings; however, severe complications may sometimes occur. If upper airway obstruction develops as in the present case, then emergency airway management must also be considered and conscientious observation is necessary.
Highlights
Anesthesia mumps consists of acute and transient salivary gland swelling caused by general anesthesia
We include discussion on imaging evaluation—since preoperative and postoperative neck computed tomography (CT) images were available for this patient partly because neck surgery was performed—and a brief literature review
The patient was admitted to the intensive care unit (ICU) in a lucid state with a blood pressure of 120/70 mmHg, a heart rate of 110 beats/min, oxygen saturation of 100% on 3 L of nasal oxygen and respiratory rate of 12 breaths/min
Summary
Anesthesia mumps consists of acute and transient salivary gland swelling caused by general anesthesia It is an extremely rare postoperative complication and occurs following various surgical procedures. The patient was admitted to the intensive care unit (ICU) in a lucid state with a blood pressure of 120/70 mmHg, a heart rate of 110 beats/min, oxygen saturation of 100% on 3 L of nasal oxygen and respiratory rate of 12 breaths/min His arterial blood gas analysis was normal, and mild hoarseness was noted without swelling of the neck or stridor. Blood test results revealed a leukocyte count of 8000/μL (eosinophils 0%), amylase at 1790 U/L, mumps immunoglobulin G (IgG) at 16.6 (+), mumps IgM at 0.27 (−), and C-reactive protein at 0.18 Based on these findings, we concluded that the patient had previously suffered from a mumps infection, but had no active disease.
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