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    Sialolithiasis

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    Hemant Baonerkar
    The 15-year-old male presented with pain and swelling in his jaw that began the day before. On physical exam, his left neck below the jaw was swollen, tender, and slightly red. His white blood cell count was increased with a left shift. Rapid strep test and mono spot were negative. The diagnosis was sialolithiasis with secondary sialadenitis. Sialolithiasis is stone formation in a salivary gland, usually caused by dehydration or medications that decrease saliva production, which can lead to bacterial infection. Treatment included warm compresses, pain medication, oral fluids, antibiotics, and massage or duct cannilation of the affected gland may help remove stones and reduce symptoms.

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    Sialolithiasis

    Uploaded by

    Hemant Baonerkar
    145 views15 pages
    The 15-year-old male presented with pain and swelling in his jaw that began the day before. On physical exam, his left neck below the jaw was swollen, tender, and slightly red. His white blood cell count was increased with a left shift. Rapid strep test and mono spot were negative. The diagnosis was sialolithiasis with secondary sialadenitis. Sialolithiasis is stone formation in a salivary gland, usually caused by dehydration or medications that decrease saliva production, which can lead to bacterial infection. Treatment included warm compresses, pain medication, oral fluids, antibiotics, and massage or duct cannilation of the affected gland may help remove stones and reduce symptoms.

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    detail about sialolithiasis. and its managment.

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    The 15-year-old male presented with pain and swelling in his jaw that began the day before. On physical exam, his left neck below the jaw was swollen, tender, and slightly red. His white blood cell count was increased with a left shift. Rapid strep test and mono spot were negative. The diagnosis was sialolithiasis with secondary sialadenitis. Sialolithiasis is stone formation in a salivary gland, usually caused by dehydration or medications that decrease saliva production, which can lead to bacterial infection. Treatment included warm compresses, pain medication, oral fluids, antibiotics, and massage or duct cannilation of the affected gland may help remove stones and reduce symptoms.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    145 views15 pages

    Sialolithiasis

    Uploaded by

    Hemant Baonerkar
    The 15-year-old male presented with pain and swelling in his jaw that began the day before. On physical exam, his left neck below the jaw was swollen, tender, and slightly red. His white blood cell count was increased with a left shift. Rapid strep test and mono spot were negative. The diagnosis was sialolithiasis with secondary sialadenitis. Sialolithiasis is stone formation in a salivary gland, usually caused by dehydration or medications that decrease saliva production, which can lead to bacterial infection. Treatment included warm compresses, pain medication, oral fluids, antibiotics, and massage or duct cannilation of the affected gland may help remove stones and reduce symptoms.

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    Download as ppt, pdf, or txt
    of 15

    By Erik Paulson, D.O.

    History
    CC- 15 y.o. male c/o pain and swelling in jaw. Began yesterday, thought it might be strep

    throat or something so he began taking left over Amoxicillin from last year. NKDA Seasonal allergies relieved by Claritin and Benadryl. No other meds Vaccinations up to date

    Physical exam
    Vitals- 101.2, 95, 16, 122/80 Swollen, tender and slightly erythematous
    area on left side of neck just inferior to mandible. Decreased in size after pressure was applied.

    Differential Diagnosis
    Infection
    Lymphadenitis Mono Strep Sialadenitis Mumps- vaccinations are up to date Stone Sjogrens Abscess

    Neoplastic

    Labs
    CBC- Increased white count w/ left shift Rapid strep Mono spot All other labs normal

    Diagnosis
    Sialolithiasis with secondary sialadenitis

    Quiz time
    Duct from Parotid gland is called?
    Stensens duct

    Duct from Submandibular gland is called?


    Whartons duct

    Pathophysiology
    Dehydration
    Concentration of saliva

    Fasting or Anorexia
    Stasis of saliva

    Drugs- Anti-histamines, Anti-cholinergics.


    Decrease production of saliva

    Stone can cause stasis of saliva and subsequent


    bacterial ascent into the gland.
    Infection most commonly from S. aureus or Strep Viridans.

    Fun Facts about Sialolithiasis


    Twice as common in males 1% incidence at autopsy Stones are usually made of calcium
    phosphate

    Treatment
    Conservative
    Warm compresses Sour candy Pain relief- Ibuprofen 800mg. PO Q8hrs PRN pain. Oral fluids Discontinue anti-histamines Oral antibiotics- Cefalexin 500mg PO QID X 7d.

    Surgical

    Lithotripsy

    Wire basket retrieval under fluoroscopy. Duct cannulation Gland removal for recurrent cases

    Osteopathic treatment
    Gentle massage of the salivary gland may free
    calculi that are near the end of the duct. It may also decrease the amount of saliva retained in the gland and provide symptomatic improvement. Lymphatic pumps to improve immune function. Increase/ normalize parasympathetic tone, decrease/ normalize sympathetic tone.

    Outcome
    Unknown, but he did not return to the ED
    within the next two weeks.

    References
    http://0www.utdol.com.library.touro.edu/online/content /topic.do?topicKey=prim_ent/7995&selectedTitle =1~2&source=search_result http://www.learningradiology.com/archives04/C OW%20096-Sialolithiasis/sialolithcorrect.htm http://www.emedicine.com/ent/topic598.htm

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