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Paper accepted 23 December 1981 .

Br. J. Surg. Vol. 69 (1982) 379 Printed in Great Britain

Submandibular salivary duct calculus

secondary t o a foreign body
R . M. Watkins
Kent and Sussex Hospital, Tunbridge Wells, Kent

Foreign bodies are a rare cause of salivary duct calculi (1).

However, a variety of objects has been identified, including
toothbrush bristles, slivers of finger nails, fish bones, wood
splinters and hairs. Only two cases have been repoited in which
submandibular duct obstruction was due to a blade of grass
(2,3).
Case report
A 23-year-old woman presented with a painful swollen left
submandibular gland. She gave a history that, 4 weeks before, when
chewing a piece of grass, she lost it below her tongue.
She had a large tender submandibular gland and a few beads of pus
could be expressed from the orifice of the duct. X-rays of the floor of
the mouth showed no evidence of a radio-opaque calculus.
At operation, the orifice of the left submandibular duct was dilated
and a blade of grass approximately 2cm long was removed. The part
nearer to the submandibular gland was encrusted with dense calculous Fig. 1. A blade of grass (approximately 2 cm) with hard calculous
material (Fig. I). A large amount of pus then drained from the duct and encrustation removed from the duct.
the patient made an uneventful recovery.

Discussion References
reports (2,3) included detailed and 1. Pratt L. w.: Foreign body of Wharfon’s duct with
Both previous similar formation. Ann. Otol. Rhinol. Laryngol. 1968; 11:88-93.
accurate histories that a piece of grass had been lost below the 2, cosens C , and Smith T, R,: T~~ ofimpaction o f a vegetable
tongue just before the symptoms started. Many surgeons may foreign body, one in the submaxillary, the other in the sublingual
find it difficult to believe that a foreign body could enter the salivary duct, leading to obstruction of the duct and formation of
submandibular duct accidentally, knowing how difficult it can an abscess in the gland. Sr Bartholomew’s Hosp. Rep. 1897; 3 3
be to probe the submandibular duct‘ In both previous reports 105-8.
3. Pilcher J. A,: Salivary calculus containing a foreign body: report
there was considerable delay in diagnosis and appropriate of a case. Arch. Otolaryngol. 1937; 26: 531-3.
treatment: in one it was 12 vears. Probablv the delav was
because of difficulty in acceptihg the patient’s history. Paper accepted 8 May 1981.