Symmetrical Neck Swelling After Percutaneous Coronary Intervention.

Area of Science:

• Radiology
• Allergology
• Emergency Medicine

Background:

• Cervical edema post-iodinated contrast media can indicate hypersensitivity reactions.
• Differential diagnoses are crucial for accurate patient assessment.

Purpose of the Study:

• To present a rare case of contrast-induced sialadenitis.
• To outline an approach for evaluating cervical edema after contrast media administration.

Main Methods:

• Case report of a patient with submandibular swelling post-percutaneous coronary intervention.
• Cervical computerized tomography (CT) for imaging.
• Allergy testing including skin prick, intradermal, epicutaneous, and drug provocation tests with alternative contrast media.

Main Results:

• CT revealed submandibular gland enlargement and fat stranding, suggesting contrast-induced sialadenitis.
• Allergy tests for iodinated contrast media and alternatives were negative.
• Drug provocation tests with alternative iodinated contrast media were also negative.

Conclusions:

• Cervical edema after iodinated contrast media requires considering diagnoses beyond hypersensitivity.
• Contrast-induced sialadenitis is a rare but possible diagnosis.
• An algorithm involving allergy testing is proposed for managing such cases.