Li Wanqiang, Liao Zhengquan, Yao Ling, Zhang Lusheng, Li Xuesong, Dong Ziqiang
Department of Urology, the First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, China.
Department of Urology, Yidu People's Hospital, Yichang, China.
Front Surg. 2023 Jan 6;9:1039362. doi: 10.3389/fsurg.2022.1039362. eCollection 2022.
Anesthesia mumps have rarely been reported. This article presents the diagnosis and treatment of a case of anesthesia mumps with airway obstruction in the urology department and reviews previous cases of the disease. A 58-year-old man had a history of hypertension and diabetes, and his blood pressure and glucose levels were well controlled. He underwent laparoscopic radical nephrectomy for a right renal tumor. Postoperatively, a swelling of approximately 5 × 4 cm was observed in the left parotid region and left eyelid, no palpable crepitation was detected, and the skin overlying the left parotid gland was mildly hyperemic and tender. Enhanced computed tomography of the head and neck revealed obvious swelling of the laryngopharyngeal airway, and electronic laryngoscopy showed narrow airway. Laboratory test results including white blood cell count, C-reactive protein, serum amylase, and lipase levels were normal. Glycosylated hemoglobin level was 6.8%, and the salivary culture from Stensen's duct was negative. The patient was managed with endotracheal intubation and a ventilator to maintain breathing along with anti-infection, expectorant, and symptomatic treatment. The swelling in the left parotid gland gradually resolved without recurrence, and the patient was extubated on the 7th postoperative day. In this case, the pathophysiology of anesthesia mumps may have been related to the incorrect positioning of the thick short neck and the use of a head ring, which can result in the squeezing of vessels. In most cases, the salivary gland swelling resolves with observation and symptomatic treatment. In patients with anesthesia mumps, emergency airway management and careful observation are necessary if upper airway obstruction occurs. This case report should increase awareness of anesthesia mumps and its complications among anesthesiologists, surgeons, and postoperative caregivers.
麻醉性腮腺炎鲜有报道。本文介绍了泌尿外科一例伴有气道梗阻的麻醉性腮腺炎的诊断和治疗,并回顾了该疾病的既往病例。一名58岁男性有高血压和糖尿病病史,其血压和血糖水平控制良好。他因右肾肿瘤接受了腹腔镜根治性肾切除术。术后,左侧腮腺区和左眼睑出现约5×4 cm的肿胀,未触及捻发音,左侧腮腺上方皮肤轻度充血且压痛。头颈部增强计算机断层扫描显示喉咽气道明显肿胀,电子喉镜检查显示气道狭窄。包括白细胞计数、C反应蛋白、血清淀粉酶和脂肪酶水平在内的实验室检查结果均正常。糖化血红蛋白水平为6.8%,腮腺导管唾液培养结果为阴性。患者接受气管插管和呼吸机辅助呼吸,并给予抗感染、祛痰及对症治疗。左侧腮腺肿胀逐渐消退,未复发,患者于术后第7天拔管。在本病例中,麻醉性腮腺炎的病理生理学可能与粗短颈部的不正确体位及头圈的使用有关,这可能导致血管受压。在大多数情况下,唾液腺肿胀通过观察和对症治疗即可消退。对于麻醉性腮腺炎患者,若发生上气道梗阻,紧急气道管理和密切观察是必要的。本病例报告应提高麻醉医生、外科医生及术后护理人员对麻醉性腮腺炎及其并发症的认识。