Fractured Submandibular Gland

Roebker, James; Hall, Larry C.; Lukin, Robert R.

doi:10.1097/00004728-199111000-00037

Cited by 14 publications

(12 citation statements)

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“…CT is commonly used for imaging of salivary glands after blunt or penetrating trauma, but radiation risk and expertise in the evaluation are crucial for a definite diagnosis. Few cases of blunt submandibular gland injuries that are reported in the literature used CT for diagnosis, but bedside ultrasound can provide rapid diagnosis in trauma patients (3,10). Our case demonstrates the use of bedside ultrasound by emergency physicians for rapid diagnosis of a rare form of trauma.…”

Section: Discussionmentioning

confidence: 75%

“…Computed tomography is an accurate method for diagnosing, as it is readily available in the ED and visualizes the surrounding bony structures. Expected findings in CT include inflammation, edema, and fat stranding (2). Whether contrast medium use is needed for visualization is a matter of debate, as some authors suggest that hemorrhage may be hard to distinguish from the glandular parenchyma in postcontrast images (3).…”

Section: Discussionmentioning

confidence: 99%

“…Management of a submandibular gland injury starts with airway protection, where progressive swelling can lead to airway compromise in the acute setting or can delay up to 36 hours (2,5). The required time of observation is uncertain, as some authors suggest that a prolonged time of observation is needed for patients with potential airway compromise (5).…”

Section: Discussionmentioning

confidence: 99%

“…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%

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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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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Delayed Presentation of Blunt Neck Trauma Diagnosed with Bedside Ultrasonography

Akay¹,

Akay²,

Erkan³

2014

JAEMCR

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“…Of the three paired salivary glands, the parotid glands, which harbor the facial nerve and important vessels of the face, are more prone to injury compared with the sublingual and submandibular glands, as the latter two glands are located deeper within the mandibular arch. 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: 99%

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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