Clinical Cases

A Case of Sialolithiasis

Dr. Jyothi S. Chandran presents a case of sialolithiasis (salivary calculi) in a boy of eleven. Irritability in children, quarrelsome, swelling of cheeks, burning pain in stomach and lack of vital heat were symptoms leading to the simillimum.

Sialolithiasis also termed salivary calculi, is a condition where a calcified mass or sialolith forms within a salivary gland, usually in the duct of a submandibular gland (Wharton’s duct). Less commonly the parotid gland or a minor salivary gland may develop salivary stones.

CAUSES:  Sjogran’s syndrome, or an increase in local levels of calcium but in many instances the cause is unknown.

SIGNS &SYMPTOMS:

  • pain,
  • tenderness,
  • palpable hard lump
  • lack of saliva
  • pus discharging from the duct
  • cervical lymph adenitis
  • bad breath
  • Pain and swelling with the sight, thought, smell, or taste of food, or with hunger or chewing. It is often called a mealtime syndrome.

DIAGNOSIS :

  • HISTORY AND PHYSICAL EXAMINATION
  • X-RAY
  • ULTRA SONOGRAM.

CASE

A boy aged 11 years was suffering from pain and swelling of left cheek while eating, for the last 3 months.

Patients H/O:

Since childhood he had recurrent attacks of allergic rhinitis and asthma. Burning in abdomen since childhood after taking oily food or chicken.

Circumcision done at the age of 9 years

Family history: renal calculi – mother, grandfather (maternal)

Personal history: The child’s family is of moderate socio- economic status. Parents are teachers. Both the maternal and paternal grandparents were employees.

His father expired due to glioma. Later, most of the time he was with mother and her parents.

He is average in his studies and good in all activities

Mental symptoms: highly irritable++, impatient+, destructive, quarreling+ (only with his family members), creative, talks very loudly++

Physicals:  appetite: decreased, thirst: decreased, bladder and bowels: normal, sweat: increased on head and neck.

Blackish discoloration of teeth

Desire: fried foods, baked foods, non- veg

Aversion: vegetables

INVESTIGATION

USG NECK: On 26. 4 .2017 shows: 2mm sized calculus at origin of left Wharton duct – Sialolithiasis.

Rubrics:

Mind- Anger

Mind- Impatience

Mind-Irritability, children in

Mind- Quarrelsome

Face –Swelling-Cheeks

Stomach- Pain-Burning

Generals-Food and Drinks – Spices – Desire

Generals- Heat- Lack of Vital Heat

Rx: AURUM MET 1M /1dose (HS)     01 – 05 – 2017

06.06 2017:  Pain in left cheek persisting, swelling feels better, no complaint of rhinitis or asthma,  appetite: reduced, all other generals: good

22.11.207  – USG NECK: left Wharton’s duct shows normal in calibre and shows a calculus measuring 3×2.7mm at the origin.

AURUM MET 1M/IDOSE (HS)

30.04 .2018 – USG NECK: the parotid, sublingual and sub mandibular gland shows normal size and eco texture and no calculi.

Normal sonological study of neck

About the author

Jyothi Chandran

Jyothi Chandran

Dr Jyothi S Chandran is PG scholar (Dept. of Materia Medica) at Father Muller Homoeopathic Medical College. She graduated from Sarada Krishna Homoeopathic Medical College.

1 Comment

  • Dear Dr., I have the same thing going on and NO Dr has been able to diagnose, leave alone treat what I suspect is Sialolithiasis. Can I meet with you? Where are you located?

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