面颊拍击后孤立性腮腺炎：一例病例报告及临床意义

文献信息

中文摘要

背景： 腮腺炎是腮腺的炎症，最常归因于感染、唾液腺导管阻塞或自身免疫性疾病；创伤诱发的腮腺炎不常见，且钝性创伤病例的报告频率低于穿透性损伤。
病例介绍： 我们描述了一名4岁男孩，在玩耍时被低速拍击面颊后一天，因左侧面部肿胀就诊于急诊科。检查显示左侧腮腺肿胀伴压痛，无瘀伤，疼痛限制性张口受限，无面神经、耳科、口腔或颞下颌关节异常；全身皮肤检查和针对非意外伤害的正式社会工作评估均无异常。由于损伤机制需要澄清，且临床上最初无法排除下颌骨骨折，遂行计算机断层扫描，显示腮腺增大伴邻近脂肪条索影，无骨折。血清淀粉酶显著升高，炎症标志物正常，病毒血清学阴性，在系统排除感染性、梗阻性和化脓性病因后，支持创伤性腮腺炎的诊断。患儿接受保守治疗，并在两周内完全康复。
结论： 本病例为创伤后腮腺炎的有限文献增添了内容，说明即使是低速的日常机制，如拍击，也可在儿童中产生孤立性腮腺肿胀，这种关联此前未在高能量钝性创伤之外被强调。它突出了在此表现中结构化鉴别诊断、合理影像学检查和常规保护性评估的价值。

英文摘要

BACKGROUND: Parotitis, inflammation of the parotid gland, is most commonly attributed to infection, salivary duct obstruction, or autoimmune disease; trauma-induced parotitis is uncommon, and blunt-trauma cases are reported less frequently than penetrating injury.
CASE PRESENTATION: We describe a 4-year-old boy who presented to the emergency department with left-sided facial swelling one day after a low-velocity slap to the cheek during play. Examination showed tender left parotid swelling without bruising, pain-limited trismus, and no facial nerve, otologic, oral cavity, or temporomandibular joint abnormalities; a whole-body skin survey and a formal social-work assessment for non-accidental injury were unremarkable. Computed tomography, obtained because the mechanism of injury required clarification and mandibular fracture could not initially be excluded on clinical grounds, showed parotid enlargement with adjacent fat stranding and no fracture. Markedly elevated serum amylase, with normal inflammatory markers and negative viral serology, supported a diagnosis of traumatic parotitis after systematic exclusion of infectious, obstructive, and suppurative causes. The child was managed conservatively and recovered fully within two weeks.
CONCLUSION: This case adds to the limited literature on post-traumatic parotitis by illustrating that even a low-velocity, everyday mechanism such as a slap can produce isolated parotid swelling in children, an association not previously emphasized outside higher-energy blunt trauma. It highlights the value of a structured differential work-up, judicious imaging, and routine safeguarding assessment in this presentation.