Acute postsurgical suppurative parotitis: current prevalence at Hospital das Clínicas, São Paulo University Medical School

Abstract

SUMMaRyPostsurgical acute suppurative parotitis is a bacterial gland infection that occurs from a few days up to some weeks after abdominal surgical procedures. In this study, the authors analyze the prevalence of this complication in Hospital das Clínicas/São Paulo University Medical School by prospectively reviewing the charts of patients who underwent surgeries performed by the gastroenterological and general surgery staff from 1980 to 2005. Diagnosis of parotitis or sialoadenitis was analyzed. Sialolithiasis and chronic parotitis previous to hospitalization were exclusion criteria. In a total of 100,679 surgeries, 256 patients were diagnosed with parotitis or sialoadenitis. Nevertheless, only three cases of acute postsurgical suppurative parotitis associated with the surgery were identified giving an incidence of 0.0028%. All patients presented with risk factors such as malnutrition, immunosuppression, prolonged immobilization and dehydration. In the past, acute postsurgical suppurative parotitis was a relatively common complication after major abdominal surgeries. Its incidence decreased as a consequence of the improvement of perioperative antibiotic therapy and postoperative support. In spite of the current low incidence, we believe it is important to identify risks and diagnose as quick as possible, in order to introduce prompt and appropriate therapeutic measures and avoid potentially fatal complications with the evolution of the disease.

Postoperative infection of the skull base surgical site due to suppurative parotitis: A case report

“…Postoperative parotitis is rare and is detrimental to a patient's recovery[ 9 ]. Due to the close relationship between the parotid gland and the surgical site at the skull base, once suppurative parotitis occurs, the inflammation may spread to the operative area where the transposed free fat tissue can become infected or necrotic.…”

“…In severe cases, meningitis and even encephalitis are possible and are life-threatening[ 4 ]. Through the review of this case, the occurrence of suppurative parotitis 25 d after surgery may be related to insufficient oral food intake and decreased parotid gland secretion[ 9 ]. It is necessary to pay attention to the patient's oral intake after surgery; therefore, timely intervention is needed if there is insufficient food intake.…”

Acute Parotitis after Lower Limb Amputation: A Case Report of a Rare Complication

“…Furthermore, the patient was malnourished, was diabetic for years, and had chronic renal failure. All these three factors are major contributors for postoperative acute parotitis, possibly because of the generalized immunosuppression state created by them [ 3 ].…”

“…Postoperative parotitis has been described as a complication of abdominal surgery [ 2 ]. The reported incidence in a large retrospective study was as low as 0.0028% [ 3 ]. Except from abdominal, acute parotitis has also been described in other types of operations such as those of neurosurgery field [ 4 ].…”

Factors Predicting Length of Stay in Patients Hospitalized for Acute Parotitis

“…In the past, postsurgical ASP was a relatively common complication after major surgeries; however, its incidence is decreasing. 18 Our cohort included patients with dehydration from causes other than surgery, although the pathogenesis is the same. Although other comorbidities might contribute to the development of ASP, we did not have these data in our study.…”