Acute bilateral transient sialadenitis – “anesthesia mumps” following robotic prostatectomy: a case report

Introduction and importance: Acute transient swelling of parotid glands also known as “anesthesia mumps” is a rare postoperative complication following epidural, spinal, or general anesthesia. This is commonly known as anesthesia mumps, surgical mumps or acute postoperative sialadenitis. It is usually a benign condition, that may present as unilateral or bilateral swelling up to 24-hrs after surgery. The swelling is temporary and may last for several minutes to several days. Case presentation: Herein, we present a case of bilateral acute postoperative sialadenitis that developed the next day after a robotic prostatectomy and resolved spontaneously 1 week after with conservative management. Clinical discussion: The pathophysiology of this condition remains elusive, and many factors are thought to play a role. Possible causes include increased saliva viscosity secondary to dehydration or drugs, and obstruction of the glandular excretory ducts caused by the position of patient, calculi, or thickened secretions. In our case, the anesthesia mump was probably multifactorial. The swelling was possibly due to a combination of fluid restriction leading to dehydration, and the prolonged steep trendelenburg position which could have resulted in the compression of the parotid gland. Conclusion: Anesthesiologist, surgeons, and caregivers should be aware of this complication especially when the patient is placed in a steep trendelenburg position for a prolonged time.