Salivary Gland Pathology. Группа авторов

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Название Salivary Gland Pathology
Автор произведения Группа авторов
Жанр Медицина
Серия
Издательство Медицина
Год выпуска 0
isbn 9781119730224



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Malnutrition Medications Antihistamines Diuretics Tricyclic antidepressants Phenothiazines Antihypertensives Barbiturates Anti‐sialogogues Anticholinergics Chemotherapeutic agents Sialolithiasis Oral infection Non‐modifiable risk factors Advanced age Relatively non‐modifiable risk factors Radiation therapy where cytoprotective agents were not administered Renal failure Hepatic failure Congestive heart failure HIV/AIDS Diabetes mellitus Anorexia nervosa/bulimia Cystic fibrosis Cushing disease

      The formal history taking process begins by obtaining the patient's chief complaint. Sialadenitis commonly begins as swelling of the salivary gland with pain due to stretching of that gland's sensory innervated capsule. Patients may or may not describe the perception of pus associated with salivary secretions, and the presence or absence of pus may be confirmed on physical examination.

      History taking is important to disclose the acute or chronic nature of the problem that will significantly impact on how the sialadenitis is ultimately managed. Regarding the prognosis and the anticipation for the possible need for future surgical intervention, an acute sialadenitis is somewhat arbitrarily classified as one where symptoms are less than one month in duration, while a chronic sialadenitis is defined as having been present for longer than one month. In addition, the history will permit the clinician to assess the risk factors associated with the condition. In so doing, the realization of modifiable versus relatively non‐modifiable versus non‐modifiable risk factors can be determined. For example, dehydration, recent surgery, oral infection, and some medications represent modifiable risk factors predisposing patients to sialadenitis. On the other hand, advanced age is a non‐modifiable risk factor, and chronic medical illnesses and radiation therapy constitute relatively non‐modifiable risk factors associated with these infections. The distinction between modifiable and relatively non‐modifiable risk factors is not intuitive. For example, dehydration is obviously modifiable. The sialadenitis associated with diabetes mellitus may abate clinically as evidenced by decreased swelling and pain; however, the underlying medical condition is not reversible. The same is true for HIV/AIDS. While much medical comorbidity can be controlled and palliated, these conditions often are not curable such that patients may be fraught with recurrent sialadenitis at unpredictable time frames following the initial event. As such, these and many other risk factors are considered relatively non‐modifiable.

Photos depict a 35-year-old man with a toxic megacolon (a) associated with Clostridium difficile diarrhea. He developed a left parotitis (b and c) due to a severe depletion of his intravascular volume. Photo depicts a severe case of hospital acquired parotitis related to insufficient rehydration of this patient. Photo depicts a mild case 
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