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Clinical Problem Solving: Radiology
Oct 2011

Radiology Quiz Case 3: Diagnosis

Arch Otolaryngol Head Neck Surg. 2011;137(10):1042. doi:10.1001/archoto.2011.167-b

Diagnosis: Bilateral self-induced pneumoparotitis

Pneumoparotitis is a rare cause of parotid swelling that is caused by the reflux of air through the Stensen duct into the parotid ductal system. Although pneumoparotitis is a rare condition, it should be included in the differential diagnosis during evaluation because its symptoms can be easily confused with recurrent parotitis of infectious origin. As in this case, at presentation patients can complain of swelling and pain over the parotid gland, while appearing nontoxic and afebrile. Physical examination can yield crepitus during palpation over the gland, along with frothy saliva or frank bubbles of air from the parotid duct. Pneumoparotitis, although clearly significant for the otolaryngologist, has been reported to be a condition of importance in several different disciplines, from anesthesiology to psychiatry. It is no surprise, then, that the causes of pneumoparotitis are many and that the treatment course can be affected by the different causative factors.

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