Blunt submandibular gland trauma: acute CT findings

Tonerini, Michele; Fratini, Luisa; Grassi, L; Ravenna, Virginia; Tozzini, A; Trincavelli, F; Orsitto, E

doi:10.1007/s10140-002-0204-0

Cited by 9 publications

(12 citation statements)

References 4 publications

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“…1 Because of their location, submandibular gland fractures are rare and most often associ- continued from page 56 ated with mandibular or zygomatic bone fractures. 2,3 In the case discussed here, the blunt trauma to the neck resulted in an isolated fracture of the submandibular gland, with no complications of other glands or structures surrounding it.…”

Section: Discussionmentioning

confidence: 78%

“…2 The cornerstone in evaluating these injuries is to thoroughly examine the site of injury and anticipate the signs and symptoms that may be included in the presentation. Proper assessment of these injuries should include a complete head and neck examination for cutaneous, skeletal, dental, vascular, nervous, and salivary duct injuries to prevent further complications and morbidity.…”

Section: Discussionmentioning

confidence: 99%

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A 6-Year-Old Female with Unilateral Cervical Swelling

Aggarwal¹,

Shaheen²

2015

Pediatr Ann

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Editor's note: Each month, this department features a discussion of an unusual diagnosis. A description and images are presented, followed by the diagnosis and an explanation of how the diagnosis was determined. As always, your comments are welcome via email at pedann@Healio.com. For diagnosis, see page 58Case Challenge A 6-year-old female was brought to the emergency department 6 hours after sustaining blunt trauma to the neck. She was playing outside her house when a small motorized bicycle fell on her neck. She was in mild discomfort immediately after the injury and developed significant swelling with tenderness over the following hours. She complained of pain upon swallowing and pain with movement of the neck. She had no significant medical history or prior trauma. Her vaccinations were current and no ill contacts were identified. Her growth and developmental milestones were all attained in normal stages.On physical exam, she was afebrile. No evidence of erythema or ecchymosis was seen. She exhibited left-sided cervical swelling that was warm to the touch and tender below the left submandibular angle (Figure 1). She demonstrated limited cervical range of motion. Kernig's and Brudzinski's signs were negative. Inspection of her oropharynx showed no lesions, erythema, exudates, or edema. On palpation, a 3.5-cm × 2-cm mass was found in the left submandibular region and a 1.5-cm × 1-cm posterior cervical lymph node was palpated.Her initial labs showed marked leukocytosis. Sonographic studies revealed an isoechoic mass in the left upper neck. Computed tomography angiography of the neck with contrast demonstrated no vascular injury. A computed tomography (CT) scan of the neck confirmed the absence of any bony fractures and revealed the diagnosis (Figures 2 and 3).

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

A 6-Year-Old Female with Unilateral Cervical Swelling

Aggarwal¹,

Shaheen²

2015

Pediatr Ann

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“…Künt travmalar parankimal kontüzyon, hematom veya laserasyon ve bazen de fibrozis, sialadenit, sialosel veya mukosel formasyonuna neden olurken, penetran yaralanmalar duktal lezyonlar ve sıklıkla fistül oluşumuna yol açar (2). Duktal laserasyon saptandığında, bu gibi komplikasyonların gelişme riski yüksek olduğundan, acil cerrahi onarım düşünülmelidir (7,8). Hastamızda izole künt yaralanma olması ve komplikasyon gelişmemesi nedeniyle konservatif yaklaşımı tercih ettik.…”

Section: Discussionunclassified

“…Bu amaçla ikinci ve üçüncü kuşak sefalosporinler, penisilinler veya klindamisin seçilebilir. Antikolinerjiklerin, tükürük üretim ve akımını yavaşlatması ve bez irritasyonunu azaltması nedeniyle prognozu iyileştirdiğini gösteren çalışmalar mevcuttur (7,10). Üriner retansiyon, fotofobi ve taşikardi gibi yan etkileri ise kullanımlarını kısıtlar.…”

Section: Discussionunclassified

Isolated Blunt Submandibular Gland Injury after a Fall from a Bicycle

Ekinci¹,

Aktaş²,

Demirtas³

et al. 2015

JAEMCR

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Introduction:Injury to deep neck structures should be considered during emergency room (ER) admissions in patients with a chief complaint of swelling in the neck, particularly when there is a history of trauma to the neck. Life-threatening conditions should be assessed, diagnosis should be made using appropriate imaging modalities, and treatment should be planned accordingly. Case Report: A 30-year-old male presented to the ER with the chief complaint of a swollen neck 2 h after he fell off a bicycle. Based on the ultrasound and computed tomography analysis, he was diagnosed with isolated submandibular injury. Conclusion: Isolated submandibular injury following a blunt trauma is a rare condition. Obtaining appropriate imaging modalities is helpful in confirming the diagnosis. Patients with blunt trauma should also be carefully assessed for other, nonapparent injuries. Giriş Parotis, submandibular ve sublingual bezler majör tükürük bezleridir. Bu bezlerin izole yaralanmaları oldukça seyrektir. Submandibular ve sublingual bez yaralanmaları anatomik pozisyonları nedeniyle parotis bezi ve tükürük kanal yaralanmalarından daha nadir görülür. Etiyolojiden çoğunlukla penetran travmalar sorumludur (1). Bu yazıda, bisikletten düşme sonucu izole künt submandibular bez yaralanması meydana gelen bir olgu sunulmuştur. Olgu SunumuOtuz yaşında erkek hasta, acil servise gelmeden yaklaşık 2 saat önce bisikletten düşme ve sonrasında sağ boyun bölgesinde şişlik oluşması şikayetleriyle başvurdu. Düştüğünde çene ve boyun bölgesini, sivri olmayan sert bir zemine çarptığını belirtti. Boynundaki şişliği, çarptıktan yaklaşık 1 saat sonra fark ettiğini ve bu bölgede boyun hareketleriyle hafif derecede ağrı olduğunu ifade etti. Yutkunma güçlüğü veya nefes darlığı gibi solunum yolunu tehdit eden bir semptom bulunmamaktaydı. Hastanın 56

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“…The parotid gland is more susceptible to trauma, as the submandibular gland is protected by the mandibular arch. Few reports of blunt trauma to the submandibular glands are caused by motor vehicle collision (MVC), where patients present after a delay of time (2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Delayed Presentation of Blunt Neck Trauma Diagnosed with Bedside Ultrasonography

Akay¹,

Akay²,

Erkan³

2014

JAEMCR

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Introduction: Trauma of the salivary glands is rare, as penetrating traumas account for the majority of them. Few cases of blunt trauma of the submandibular glands are reported in the literature. Delayed presentation and airway compromise are the main concerns. Radiologic imaging is essential for diagnosis, where emergency physicians can diagnose with bedside ultrasonography.Case Report: A 38-year-old male presented to our emergency department after discharge from another hospital following enlargement of the submandibular area. Bedside ultrasound showed enlargement of the left submandibular gland with a hypoechogenic line through the gland with preglandular fluid collection when compared to the right side. Computed tomography of the neck with intravenous contrast agent confirmed the diagnosis.Conclusion: Isolated injury of the submandibular gland is rare, where the majority of reported cases is caused by MVCs. Minor appearing trauma can cause delayed presentations where the patient can re-present to the ED with more distinct findings. A bedside ultrasonography of the involved area can detect any abnormality of the affected gland and alert the physician for any possible airway compromise in the acute setting.

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Blunt submandibular gland trauma: acute CT findings

Abstract: We describe an early CT study of a rare case of blunt traumatic injury to the right submandibular salivary gland, without mandibular bone fractures, in a 30-year-old man after a car accident.

Cited by 9 publications

References 4 publications

A 6-Year-Old Female with Unilateral Cervical Swelling

A 6-Year-Old Female with Unilateral Cervical Swelling

Isolated Blunt Submandibular Gland Injury after a Fall from a Bicycle

Delayed Presentation of Blunt Neck Trauma Diagnosed with Bedside Ultrasonography

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