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LETTER
Year : 2012  |  Volume : 58  |  Issue : 1  |  Page : 84

Organophosphate mumps- Additional mechanism


1 Department of Emergency and Critical Care, Sri Gokulam Hospitals and Research Institute, Salem, Tamil Nadu, India
2 Department of Forensic Science, Srinivas Institute of Medical Sciences and Research Centre, Mangalore, Karnataka, India
3 Department of Internal Medicine, Chennai Medical College and Research Center, Irungalur, Trichy, Tamil Nadu, India

Date of Web Publication25-Feb-2012

Correspondence Address:
S Senthilkumaran
Department of Emergency and Critical Care, Sri Gokulam Hospitals and Research Institute, Salem, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0022-3859.93261

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How to cite this article:
Senthilkumaran S, Menezes R G, Sweni S, Thirumalaikolundusubramanian P. Organophosphate mumps- Additional mechanism. J Postgrad Med 2012;58:84

How to cite this URL:
Senthilkumaran S, Menezes R G, Sweni S, Thirumalaikolundusubramanian P. Organophosphate mumps- Additional mechanism. J Postgrad Med [serial online] 2012 [cited 2019 Aug 24];58:84. Available from: http://www.jpgmonline.com/text.asp?2012/58/1/84/93261


Sir,

The report on reversible, non-infective, bilateral parotitis in organophosphate (OP) poisoning along with the mechanism highlighted by Lohiya et al. [1] , is worth reading. However, we would like to mention additional mechanisms for it. We believe that the occurrence of this unusual complication is a multifactorial incident. The parasympathetic action of OP compound causes vascular congestion in the gland and an increased secretory activity. The water loss during the secretory phase of OP poisoning leads to relative dehydration which produces more dense secretion and may predispose to mucus plug formation and results in salivary duct occlusion. [2] Atropinization decreases the water content of salivary secretions, causing thick and viscous saliva and enhances mucus plug formation. [3] During this hyposecretory phase, the salivary ducts may be partially collapsed and become occluded. The natural flow of saliva is disturbed due to intubation, and fixation of the endotracheal tube may cause retention of the secretion, and transient parotid gland enlargement occurs due to mechanical blockage of the parotid duct. [4] As a result of the inopportune combination of increased saliva secretion with insufficient drainage, the saliva accumulates in the gland and causes swelling and pain. We believe that spontaneous resolution of these symptoms is a result of the reestablishment of the balance between secretion and drainage functions over time.


 :: Acknowledgments Top


We thank Dr. K. Arthanari, MS, for his logistic support.

 
 :: References Top

1.Lohiya R, Sangle S. Uncommon manifestation of organophosphorus poisoning. J Postgrad Med 2011;57:224-5.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.Slaughter RL. Parotid gland swelling developing during peroral endoscopy. Gastrointest Endosc 1975;22:38-9.  Back to cited text no. 2
[PUBMED]    
3.Rice DH. Saliva gland physiology. Otolaryngol Clin North Am 1977;10:273-85.  Back to cited text no. 3
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4.Mandel L, Surattanont F. Bilateral parotid swelling: A review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:221-37.  Back to cited text no. 4
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2004 - Journal of Postgraduate Medicine
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