小児耳下腺膿瘍の1例

Multiple Abscesses of the Parotid Gland in a Child:Report of a Case

　はじめに

　急性化膿性耳下腺炎は日常外来診療においてしばしば遭遇するが，抗生物貿の発達により，耳下腺膿瘍に至るのは比較的まれとされている。今回われわれは，CT, MRI上，空気像と思われる円形陰影を耳下腺内に有した小児の特異な耳下腺膿瘍症例を経験した。この耳下腺内空気像には，患児が風船をふくらませた行為が関与したと考えられた。そこで，本症例を提示するとともに，耳下腺内空気像を呈するにいたった機序につき若干の考察を加えて報告する。

A 10-year-old boy presented with two masses in the diffusely swollen right parotid gland with per-sistent fever and pain. The pressure over the parotid gland produced a purulent discharge from theStenon's duct. CT and MRI demonstrated two abnormal shadows containing air and inflammatory product. The air leakage from the duct, which was raptured due to high oral pressure, subsequently induced abscess was highly suspected, because it was found that the patient habitually blew balloons before admission. Considering the possibility of undetectable multiple abscesses and for better post-operative management, superficial lobectomy of the parotid gland was performed.