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碘造影剂诱发涎腺肿胀(涎腺炎)的管理:一项观察性研究的经验

Management of iodine contrast induced salivary gland swelling (sialadenitis): experiences from an observational study.

作者信息

Saro-Buendía Miguel, Torres-García Lidia, Mossi Martínez Claudia, Battig Arriagada Eduardo, Carreres Polo Joan, Perolada Valmaña José María, Armengot Carceller Miguel

机构信息

Unit of Laryngology-Head & Neck Surgery, Department of Otorhinolaryngology, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain.

Department of Surgery, Faculty of Medicine, University of Valencia, Valencia, Spain.

出版信息

Acta Otolaryngol. 2023 Jan;143(1):64-69. doi: 10.1080/00016489.2022.2162121. Epub 2023 Jan 3.

Abstract

BACKGROUND

Iodine contrast-induced sialadenitis (CIS) is an uncommon adverse effect to iodine-containing contrast exposition. There is scarce literature about its clinical course and demography.

OBJECTIVES

(1) To determine the clinical course and management of CIS. (2) To understand if CIS might be as rare as reported.

MATERIAL AND METHODS

A 2-month prospective observational study was conducted in the emergency room of a tertiary institution. ENT physicians on call received clinical formation about CIS while emergency physicians did not. During the study period, patients admitted at the emergency room matching the clinical and radiological features of CIS, were included. Information about demographics, iodine exposure, diagnostic workup, clinical course, and management was analyzed.

RESULTS

ENT physicians on call detected 4 cases, however, emergency physicians did not. Patients were aged 68-76 years and presented a bilateral submandibular gland swelling debuting 12 to 72 h after an exposure to iodinated contrast. Characteristic ultrasonographic findings supported the diagnosis and the clinical course was self-limited after 60 to 150 h.

CONCLUSIONS AND SIGNIFICANCE

Physicians' familiarity with CIS allows its detection and avoids costly and potentially harmful therapeutic/diagnostic efforts. The incidence is probably underestimated; however, further incidence studies are needed.

摘要

背景

碘造影剂诱发的涎腺炎(CIS)是含碘造影剂暴露后一种不常见的不良反应。关于其临床病程和人口统计学的文献很少。

目的

(1)确定CIS的临床病程和管理方法。(2)了解CIS是否真如报道的那样罕见。

材料与方法

在一家三级医疗机构的急诊室进行了为期2个月的前瞻性观察研究。随叫随到的耳鼻喉科医生收到了关于CIS的临床信息,而急诊医生没有。在研究期间,纳入了在急诊室就诊且符合CIS临床和放射学特征的患者。分析了有关人口统计学、碘暴露、诊断检查、临床病程和管理的信息。

结果

随叫随到的耳鼻喉科医生检测到4例,但急诊医生未检测到。患者年龄在68 - 76岁之间,在接触碘化造影剂后12至72小时出现双侧颌下腺肿胀。特征性超声检查结果支持诊断,临床病程在60至150小时后自限。

结论与意义

医生对CIS的熟悉程度有助于其检测,并避免进行代价高昂且可能有害的治疗/诊断措施。其发病率可能被低估;然而,还需要进一步的发病率研究。

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