Post-Endoscopy Sialadenitis

A 70-year-old woman reporting 1 year of non-progressive intermittent solid dysphagia underwent an outpatient endoscopy. Endoscopy was normal, and a 54-French bougie dilator was empirically passed, which encountered moderate resistance in oral cavity. On withdrawal, no blood was noted. The dilator passed freely on the second attempt. Subsequent screening colonoscopy was uneventful. Five hours after discharge, she returned with odynophagia and pain from a tender right submandibular swelling (Figure 1). Contrast computed tomography of the neck showed submandibular sialadenitis with adjacent cellulitis (Figure 2). After 12 hours of IV clindamycin, hot compresses, and hydration, she was discharged. Given the remarkable improvement in cellulitis, we prescribed a 72-hour course of empiric oral amoxicillin/clavulanate.1 On phone follow-up, she reported total resolution of the swelling after the antibiotics.