Monday, August 8, 2011

Sonography of Wharton duct calculus- video:

Ultrasound video clip shows the dilated duct of submandibular salivary gland (also called the Wharton duct).

This patient was a young adult male with typical history of pain in the left sublingual region whilst eating. There was also accompanying swelling of the left submandibular region with pain there when eating.
The ultrasound video clip shows the dilated submandibular salivary gland duct, measuring 4 mm.! Despite my best efforts with the small parts high frequency probe I could not detect the stone in the Wharton duct.
This was how the left submandibular salivary gland looked like:

There is a mild swelling of the left submandibular salivary gland compared to the right side.

The Wharton duct is clearly seen to be considerably dilated (ultrasound image above).

How can I be sure that the tubular structure shown in previous image is the Wharton duct? I switched on the color Doppler flow imaging and found (see image above), that this was indeed the Wharton duct and not a blood vessel.

I tried my best to find the terminal part of the duct with the stone in it, but failed. Finally I used the TV (endocavity) probe and managed to find the stone in the distal end of the Wharton duct.
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