Huge Submandibular Gland Calculus in Port Harcourt: A Case Report
Keywords:
Sialolithiasis, Huge Submandibular Calculus.Abstract
Introduction: Sialolithiasis is one of the common diseases of the salivary glands most commonly affecting the submandibular gland. This report describes the case of a patient with an unusually large submandibular gland calculus (approximately 40mm x 25mm) and the management challenges encountered.
Case Summary: A 45 year old male who presented to the Accident and Emergency department of the University of Port Harcourt Teaching Hospital with a history of swelling in the right submandibular region of 9 years duration, severe pains of 5 days duration and purulent discharge of 1 day duration. Swelling was said to intermittently wax and wane over the past 9 years usually following meals.
A clinical diagnosis of Right Submandibular Abscess secondary to Right Submandibular Sialolithiasis was made, incision and drainage of the abscess done, oral antibiotics and analgesics prescribed. Following resolution of the abscess, radiological investigations were done which confirmed the diagnosis of a Right Submandibular Sialolithiasis.
He had a right submandibular gland excision done 3 weeks later with delivery of a calculus measuring 40mmx25mm following difficult dissection.
Conclusion: Surgical dissection of a huge submandibular gland with the stone en-bloc can be challenging and puts the surrounding structures at risk. An alternative technique as presented in this report is to first deliver the stone from within the gland and subsequently dissect out the gland.
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