Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 50-year-old woman presented with a 10-year history of swelling of the left cheek during and after meals. She regularly pushed the cheek hard to decrease the swelling by excreting the saliva. She did not have pain or fever. She also complained of bronchial asthma and allergic rhinitis. Magnetic resonance imaging (MRI) revealed bead-like dilatation (3x4 cm) of the left parotid duct with hypointensity on T1-weighted MRI and hyperintensity on T2-weighted MRI. Technetium 99m-pertechnetate (Tc-99m) scintigraphy demonstrated hypofunction of the left parotid gland and retention of radioactive substrate in the left parotid duct even after acid loading. Since bougienage was impossible, we decided to perform a drainage operation. We exposed, fenestrated and sutured the duct wall to the buccal mucosa to make a large orifice. We inserted a Penrose drain for 1 month to avoid stenosis of the orifice. No complication was observed postoperatively, and drainage was still adequate at the most recent examination 3 years after the operation. Smears of saliva from the parotid duct with Hansel staining revealed numerous eosinophils, and fibrinous sialodochitis was diagnosed.
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PMID:A case of severe dilatation of the parotid duct due to fibrinous sialodochitis. 1692 20

Ductal evagination is a rare condition affecting the Wharton duct. The aim of this study was to establish the incidence, imaging features and clinical significance of ductal evagination in patients undergoing submandibular gland sialography. The sialographic findings and reports of 322 patients undergoing submandibular gland sialography during the period 1998-2007 were retrospectively reviewed. Ductal evagination was identified on sialograms as a unique diverticulum, filled with contrast medium, of the Wharton duct, with a narrow neck and a blind end. A ductal evagination was found in 5/322 patients with swelling and pain in the submandibular gland. It was always located in the middle tract of the Wharton duct. Other findings were: in 5/5 patients, an enlargement of the primary and secondary ducts due to sialodochitis; in 3/5 patients, salivary stones; in 1/5 patients, a sinuous distal tract of the Wharton duct; in 2/5 patients, a stenosis of the proximal tract of the Wharton duct. In our series, the incidence of wharton duct evagination was 1.6% incidence. It may represent a form of duct wall weakness although its cause is uncertain. It is, however, a condition that needs to be highlighted on sialograms for eventual inflammatory consequences or in guiding sialoendoscopy to avoid eventual ductal perforation.
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PMID:Sialographic findings in Wharton duct evagination. 2002 14

Sialodochitis fibrinosa (or commonly known as Kussmaul Disease) is a rare salivary gland disease characterized by recurrent salivary gland swelling and pain as a result of mucofibrinous plugs. Typically patients have a history of multiply recurrent glandular swelling, dehydration and/or decreased salivary flow, thick secretions from Stensen's or Wharton's duct, and/or history of allergic diseases. Retention of mucofibrinous plugs may lead to acute suppurative parotitis and chronic sialadenitis ultimately. The diagnosis is one of exclusion, and treatment is based on symptomatology and largely supportive.
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PMID:A rare case of Kussmaul Disease (Sialodochitis Fibrinosa). 2624 13

Here we report a case of Kussmaul's disease, or sialodochitis fibrinosa. This rare disease is characterized by recurrent swelling of the salivary glands, which then discharge clots of fibrin into the oral cavity. An 80-year-old man with a history of allergic rhinitis visited our department with the chief complaint of pain in the bilateral parotid gland area on eating. An initial examination revealed mild swelling and tenderness in this region, and indurations could be felt around the bilateral parotid papillae. Pressure on the parotid glands induced discharge of gelatinous plugs from the parotid papillae. No pus was discharged, and there were no palpable hard objects. Panoramic X-ray showed no obvious focus of dental infection, and there was no calcification in the parotid gland region. Magnetic resonance imaging revealed segmental dilatation of the main ducts of both parotid ducts, with no signs of displacement due to sialoliths or tumors, or of abnormal saliva leakage. Two courses of antibiotic therapy resulted in no improvement. During treatment, gelatinous plugs (fibrin clots) obstructing the left parotid duct were dislodged by massage, which prevented further blockage by encouraging salivary outflow. The obstruction persisted in the right parotid duct, however. Therefore, the distal portion of the right parotid duct was partially resected and the opening into the mouth enlarged, which, in combination with massage, prevented further obstruction. The pain and swelling of the parotid gland and discharge of gelatinous plugs improved, with no further recurrence at 12 months postoperatively. This case is presented along with a review of the relevant literature.
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PMID:Case of Suspected Sialodochitis Fibrinosa (Kussmaul's Disease). 2732 Feb 98