Delayed Presentation of Blunt Neck Trauma Diagnosed with Bedside Ultrasonography

Abstract

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.