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Ultrasound diagnosis of acute neck pain and swelling.

Walsh RM, Harper H, Laselle B, Harrison B - West J Emerg Med (2010)

View Article: PubMed Central - PubMed

Affiliation: Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, WA.

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Physical exam was notable for a tender, firm, right-sided neck mass below the angle of the mandible and a tongue-like, soft-tissue protrusion of the right sublingual region (Figure 1)... A bedside ultrasound was performed revealing two sialoliths and ductal dilatation (Figure 2)... Otolaryngology was consulted and the stones were subsequently removed two days later via a transoral approach... Sialolithiasis occurs most commonly in the submandibular gland (80%), followed by the parotid (15%), and the sublingual (<5%)... The submandibular gland is more prone to calculi because: 1) the duct is longer and larger in diameter with slower saliva flow rates, 2) saliva flows against gravity, and 3) saliva is more alkaline, with a higher mucin and calcium content... Ultrasound clinched the diagnosis in a rapid, accurate manner and permitted the avoidance of a CT scan and the associated radiation, cost and time delays... The treatment of sialoliths generally involves conservative management... Patients with symptoms persisting for more than a few days should be referred to Otolaryngology... Sialoendoscopy, fluoroscopy-guided wire basket extraction, lithotripsy, and open surgical removal are options when expectant management fails or is inappropriate... Typically stones less than 2 mm in diameter can be treated without surgical intervention.

No MeSH data available.


Related in: MedlinePlus

A) Ultrasound of submandibular gland depicting intraductal calculus with dilated duct. B) Sublingual ultrasound (using the endocavitary transducer) showing a second intraductal calculus with continued ductal dilatation.
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f2-wjem-11-224: A) Ultrasound of submandibular gland depicting intraductal calculus with dilated duct. B) Sublingual ultrasound (using the endocavitary transducer) showing a second intraductal calculus with continued ductal dilatation.

Mentions: A 33-year-old man presented to the emergency department with two days of right-sided facial and submandibular swelling. He denied fevers, shortness of breath, difficulty swallowing or recent dental problems. The patient’s medical history was unremarkable and he had no similar prior symptoms. Physical exam was notable for a tender, firm, right-sided neck mass below the angle of the mandible and a tongue-like, soft-tissue protrusion of the right sublingual region (Figure 1). A bedside ultrasound was performed revealing two sialoliths and ductal dilatation (Figure 2). Otolaryngology was consulted and the stones were subsequently removed two days later via a transoral approach.


Ultrasound diagnosis of acute neck pain and swelling.

Walsh RM, Harper H, Laselle B, Harrison B - West J Emerg Med (2010)

A) Ultrasound of submandibular gland depicting intraductal calculus with dilated duct. B) Sublingual ultrasound (using the endocavitary transducer) showing a second intraductal calculus with continued ductal dilatation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2908672&req=5

f2-wjem-11-224: A) Ultrasound of submandibular gland depicting intraductal calculus with dilated duct. B) Sublingual ultrasound (using the endocavitary transducer) showing a second intraductal calculus with continued ductal dilatation.
Mentions: A 33-year-old man presented to the emergency department with two days of right-sided facial and submandibular swelling. He denied fevers, shortness of breath, difficulty swallowing or recent dental problems. The patient’s medical history was unremarkable and he had no similar prior symptoms. Physical exam was notable for a tender, firm, right-sided neck mass below the angle of the mandible and a tongue-like, soft-tissue protrusion of the right sublingual region (Figure 1). A bedside ultrasound was performed revealing two sialoliths and ductal dilatation (Figure 2). Otolaryngology was consulted and the stones were subsequently removed two days later via a transoral approach.

View Article: PubMed Central - PubMed

Affiliation: Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, WA.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Physical exam was notable for a tender, firm, right-sided neck mass below the angle of the mandible and a tongue-like, soft-tissue protrusion of the right sublingual region (Figure 1)... A bedside ultrasound was performed revealing two sialoliths and ductal dilatation (Figure 2)... Otolaryngology was consulted and the stones were subsequently removed two days later via a transoral approach... Sialolithiasis occurs most commonly in the submandibular gland (80%), followed by the parotid (15%), and the sublingual (<5%)... The submandibular gland is more prone to calculi because: 1) the duct is longer and larger in diameter with slower saliva flow rates, 2) saliva flows against gravity, and 3) saliva is more alkaline, with a higher mucin and calcium content... Ultrasound clinched the diagnosis in a rapid, accurate manner and permitted the avoidance of a CT scan and the associated radiation, cost and time delays... The treatment of sialoliths generally involves conservative management... Patients with symptoms persisting for more than a few days should be referred to Otolaryngology... Sialoendoscopy, fluoroscopy-guided wire basket extraction, lithotripsy, and open surgical removal are options when expectant management fails or is inappropriate... Typically stones less than 2 mm in diameter can be treated without surgical intervention.

No MeSH data available.


Related in: MedlinePlus