Self-induced pneumoparotitis – a rare case report

Pneumoparotitis (pneumoparotiditis, pneumosialoadenitis) is a rare and frequently misdiagnosed condition. Signs of subcutaneous emphysema in parotid gland, the neck or the mediastinum are alarming symptoms that should be promptly addressed. Computed tomography, which is the gold diagnostic standard, may be successfully replaced with ultrasonography in the paediatric population. Sialography has a complementary role in the imaging of the gland, and allows for parotid duct irrigation to remove deposits and prevent recurrent inflammation. The paper presents a case of a 12-year-old boy who deliberately inflated his both parotid glands for about 6 months, and thus developed parotid pneumatocele with a diameter of about 25 mm. Diagnostic imaging was extended to include autoimmune diseases. Detailed family history was obtained. Conservative treatment, including dexamethasone irrigation of the Stensen’s duct, was used and the symptoms fully resolved. A 3-month follow-up showed no increase in the size of pneumatocele or episodes of parotiditis.