Sonographic bedside detection of sialolithiasis with submandibular gland obstruction

Sialolithiasis with salivary gland obstruction is a rare disease and can mimic more frequently occurring illnesses such as facial and dental infection or abscess. Salivary stones located in the gland or duct system can be diagnosed using high-frequency sonography, and these findings can be differentiated from ultrasound appearance of cellulitis and abscess. Additional information obtained by sonography such as number, size, and location of stones help determine prognosis of stone passage and can guide initial management of the symptomatic patient in the emergency setting. We present the case of a young female coming to the emergency department (ED) with worsening left-sided jaw pain and swelling in which emergency physician-performed sonography assisted with the diagnosis of sialolithiasis and obstructive submandibular gland disease. This diagnostic approach helped successfully guide ED management of the patient without the need for computed tomography.