Differential Diagnosis for Parotid Enlargement in an Old Age Female Patient After Abdominal Surgery

• Single Most Likely Diagnosis
  • Postoperative Parotitis: This condition is a known complication following surgery, particularly in elderly patients who may have decreased saliva production and increased risk of dehydration. The stress of surgery, along with possible intubation and medication effects, can lead to parotid gland inflammation.
• Other Likely Diagnoses
  • Parotid Duct Stone (due to parotid duct obstruction): While less common than postoperative parotitis, a stone obstructing the parotid duct can cause parotid enlargement and is a plausible diagnosis, especially if the patient has a history of similar issues or risk factors for stone formation.
  • Post Intubation Trauma: Intubation during surgery can sometimes cause trauma to the parotid gland or its duct, leading to swelling. This is more likely if the intubation was difficult or if there were complications during the procedure.
• Do Not Miss Diagnoses
  • Hypercalcemia of Malignancy: Although less likely, hypercalcemia due to an underlying malignancy (which could be unrelated to the surgery) can cause a range of symptoms including muscle weakness and potentially could be associated with parotid gland enlargement in the context of a paraneoplastic syndrome. Missing this diagnosis could have significant implications for the patient's prognosis and treatment.
• Rare Diagnoses
  • Sjögren's Syndrome: An autoimmune disorder that can cause parotid gland enlargement among other symptoms. While it's less likely to present for the first time in this context, it's a rare condition that could potentially be uncovered during the investigation of parotid enlargement.
  • Warthin's Tumor or Other Parotid Tumors: Benign or malignant tumors of the parotid gland could cause enlargement. These are rare and would be unusual to first present in the postoperative period but could be considered if other diagnoses are ruled out.