sialolithiasis
Introduction
Introduction to meteorite When a stone or gland is formed in the gland duct or gland and causes a series of symptoms and pathological changes, it is called vermiculite. The main clinical manifestations are obstructive symptoms, swollen parotid gland, and the disease is rare. The incidence of middle-aged people is high. The male incidence rate is high, the submandibular adenoid is the most common, and the parotid gland is the second. The meteorite in the duct is more than the vermiculite in the sputum, and most of them are manifested by chronic inflammation. A small number of cases may be associated with biliary or urinary tract stones. basic knowledge The proportion of illness: this disease is also a common disease, the general population incidence rate is about 0.3% Susceptible people: no specific population Mode of infection: non-infectious Complications: biliary tract infections biliary stones
Cause
Cause of meteorite
Sputum retention (45%):
The cause of the detention is that the lumen of the catheter is narrowed, the tumor is compressed, or the foreign body is blocked, which causes the sputum discharge to be blocked, stagnates in the duct and acinus, and gradually concentrates, and the inorganic salt content increases and deposits to form vermiculite.
Bacteria, foreign bodies (55%):
There are bacterial infections or foreign bodies in the duct or gland, which can form the core of calcium salt deposition. The core inorganic salts are deposited layer by layer and gradually increase the formation of stones. The systemic factors such as the metabolism of the inorganic salts of the body and the colloidal state of the sputum It is closely related to the formation of vermiculite. Due to the imbalance of calcium and phosphorus metabolism, the calcium and phosphorus content in the serum increases, and the increase of calcium and phosphorus in the sputum can lead to the precipitation of inorganic salts to form stones.
Prevention
Meteorite prevention
The key to prevention is to drink more water, often taking orally magnetized water to prevent the formation of vermiculite. When there is a symptom of obstruction of the parotid duct, you can try the stone soup, eat acidic fruit, and promote the secretion of saliva. It is expected that the small meteorite will be discharged by itself. Clearly for catheter stones, should be contraindicated for parotid angiography, sometimes using a lithotripter to crush the submandibular gland and the posterior segment of the stone, can get better results.
Complication
Vermiculite complications Complications, biliary tract infection, biliary stones
Obstruction of the meteorite causes the gland to trigger an infection and recurrent.
Symptom
Symptoms of meteorite disease Common symptoms Painful and inflamed purulent secretions
Can be seen at any age, more common in middle-aged people aged 20-40. The course of illness is several days, and the elders are several years or even decades. The symptoms of small parotid stones are not obvious, and obstructive symptoms appear when large stones block the catheter and affect saliva discharge. It is characterized by each time you eat. The affected glands rapidly swell and pain, and the symptoms can be gradually reduced and resolved after eating. When using both hands for internal and external palpation, the larger stones at the front end can be touched. Care should be taken during inspection to avoid moving stones back. X-ray or B-ultrasound can display the image of the stone. Submandibular adenoids often complicated with chronic submandibular gland inflammation. At this time, the gland is swollen and hard, and the opening of the catheter is slightly red and swollen, and there is a purulent discharge.
Examine
Vermiculite examination
First, the laboratory check for easy blood calcium concentration is higher than normal. If there is a concurrent infection, the number of white blood cells can be increased in the blood test.
Second, the X-ray examination uses the bite piece to check the bottom of the mouth, and the radiation blocking area appears on the piece to confirm the diagnosis. The submandibular gland duct should be selected for the mandibular transverse sacral sac, and the posterior submandibular duct and the gland in the gland should be selected for the submandibular gland lateral radiograph. Vermiculite with a lower degree of calcification, the so-called negative meteorite, is difficult to display on X-ray films. After the acute inflammation subsides, salivary gland angiography can be performed, and the vertebra appears as a round, oval or fusiform filling defect. For patients with confirmed meteorites, no salivary gland angiography is performed to prevent the vermiculite from being pushed into the posterior or glandular canal.
Diagnosis
Diagnosis and diagnosis of meteorite
diagnosis
1. Typical parotid duct obstruction symptoms and medical history.
2. It can be used to treat catheter stones.
3. Patients with inflammation, glandular swelling and pain, redness and swelling of the catheter, and overflow of purulent secretions.
The 4.x line check shows the shape and location of the meteorite.
Differential diagnosis
First, sublingual gland benign or malignant tumors without sputum secretion and obstructive symptoms and mumps performance, X-ray examination or angiography without stones, percussive tumors were substantial, no tenderness.
Second, the submandibular gland tumor showed progressive enlargement, no history of eating swelling or inflammation of the submandibular gland. Tumor pathology can confirm the diagnosis.
Third, the submandibular space infection patients have a history of dental disease and can find the source of the teeth. The submandibular area is swollen with a hard infiltration, and the skin is flushed and can have edema. The secretion of the submandibular gland may be reduced, but the saliva is normal and there is no obstruction of the meteorite.
