Presentation
Right submandibular gland swelling, increased with eating for two weeks.
Patient Data
Right submandibular gland shows two intraglandular ductal stones with dilatation of the intraglandular ducts. It is also mildly enlarged with decreased echogenicity suggestive of secondary sialadenitis.
Case Discussion
Sialolithiasis is the most common disease of salivary glands, accounting for approximately 50% of all major salivary gland. The submandibular salivary gland is most commonly affected (80-90% of cases) with almost all the remaining cases located in the parotid duct. It is believed to be due to the increased viscosity of the secretions from the submandibular gland 1.
Patients usually presented between 30 and 60 years of age, with a male predilection. They present with a history of recurrent swelling and pain in the involved gland usually associated with eating due to obstructions of the draining duct, e.g. submandibular duct (Wharton duct) thus slowing down or disabling the flow of saliva. This, in turn, predisposes infection of the gland proximal to the obstruction, resulting in bacterial sialadenitis 1.
In chronic cases of obstruction, the gland undergoes fatty atrophy and becomes asymptomatic, unless secondarily infected.
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