Contrast-Induced Sialadenitis: An Under-Recognized Adverse Reaction in Radiology and Clinical Practice

Area of Science:

• Radiology
• Pathology

Background:

• Contrast-induced sialadenitis (CIS) is an uncommon inflammatory reaction affecting salivary glands post-iodinated contrast media (ICM) exposure.
• It presents as glandular swelling and pain, often linked to non-ionic, low-osmolar contrast agents and risk factors like iodine allergy or renal dysfunction.

Purpose of the Study:

• To present a case series of three patients experiencing sialadenitis after contrast-enhanced CT scans.
• To emphasize the importance of early recognition, differentiation from other pathologies, and adherence to preventive strategies for CIS.

Main Methods:

• Case series analysis of three patients with CIS following contrast-enhanced CT.
• Review of clinical presentations, diagnostic imaging findings (CT/ultrasound), and management strategies.

Main Results:

• Presentations varied from mild submandibular swelling to severe bilateral parotid and submandibular gland inflammation.
• Characteristic imaging findings included glandular enlargement, periglandular fat stranding, and heterogeneous enhancement.

Conclusions:

• CIS requires prompt recognition and differentiation from infectious or neoplastic conditions by radiologists.
• Preventive measures (corticosteroid premedication, hydration) and supportive management (corticosteroids, NSAIDs) are key, especially for high-risk individuals.
• Further research is needed to optimize CIS prevention and treatment strategies.