Submandibular gland abscess

Case contributed by Dr Derek Smith

Presentation

Progressive right neck swelling over a week. Now trismus and speech change. ?collection for drainage ?airway compromise

Patient Data

Age: 30 years
Gender: Male
CT

Heterogeneous enhancement of an enlarged right submandibular gland. Intragland abscess measuring 35 mm in largest dimension. Proximal duct dilatation, but no radio-opaque calculus or obstruction.

No deep neck extension. No airway compromise. Reactive nodal enlargement.

US drainage three days later

Ultrasound

Three days following the CT, the patient was referred for US guided drainage of the collection (persisting submandibular swelling).

On ultrasound, there was evidence of sialadenitis (enlarged, perigland edema, intragland duct dilatation) but the abscess was no longer visible, presumably discharged into the oral cavity in the interim.

Case Discussion

Acute right submandibular sialadenitis complicated by intragland abscess formation.

A few days later the patient attended for an ultrasound guided drainage, but the central collection had auto-discharged. No microbiology sample obtained, and the situation resolved with antibiotic therapy.

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