42 years old man with oral pain exacerbating after

 

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Doctor's Information

Name :  Mehdi
Family :Bitarafan
Email :  ----------------
Resident :  Hussein Soleiman Tabar

 

Patient's Information

Gender :  Male
Age :  42

 

Case Section

Head & Neck Imaging

 

Clinical Summary

42 years old man with oral pain exacerbating after meal

 

 

Imaging Procedures and Findings

The procedure performed is a sialography and shows dilatation of submandibular gland??s duct and a filling defect within it representing a non-opaque calculus.

 

Discussion

Salivary gland calculi may be solitary or multiple; 80% develop in the submandibular glands because these produce a more alkaline and viscous saliva and the ducts take an uphill course. Calculi form as a result of stasis or infection, and once formed predispose to further infection and stone formation. The majority are radio-opaque and may be seen on plain radiographs. Multiple calculi are more frequent in the parotid glands. Sialography can identify and locate opaque and non-opaque calculi and the associated strictures that often develop in the duct system. When a stone is large enough to produce obstruction (generally when it exceeds 3 mm in a main duct), dilatation of the proximal ducts occurs and if there is secondary infection small cavities may form within the gland (sialectasis). Calculi may also be demonstrated with ultrasound , although CT is the most sensitive of all the techniques. Unenhanced scans should be obtained to show stones and then intravenous contrast medium can be given if an abscess is suspected.

 

Final Diagnosis

Submandibular duct stone

 

References

DAVID SUTTON. TEXTBOOK OF RADIOLOGY AND IMAGING. SEVENTH EDITION.

 

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