Presentation
Pain left submandibular region.
Patient Data
A dense stone, measuring 4 x 4 x 3 mm is noted along the anatomical site of the course of the left Wharton's duct. This is associated with mild ectasia the main duct proximally (calcular obstruction of the left Wharton's duct). Normal CT features of the submandibular gland. Few small submental (level Ia) and bilateral submandibular (level Ib) adenopathy noted (reactive looking).
Bilateral elongation of styloid processes is incidentally noted.
Case Discussion
Submandibular gland/duct stones are the commonest form of sialolithiasis. It usually presents with recurrent swelling and pain at submandibular gland, especially with meals. It can predispose to infection (sialadenitis) due to obstruction. In chronic cases of obstruction, the gland undergoes fatty atrophy and becomes asymptomatic, unless secondarily infected.
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