“Sialoadenitis esclerosante crónica en un paciente geriátrico de un establecimiento de segundo nivel”

Abstract

Sclerosing chronic sialoadenitis is a disease mediated by a reactive lesion, which is usually usually a consequence of direct compression or ductal obstruction. The obstructed major salivary gland increases in size due to accumulation of secretions in the ductal system and subsequent infiltration by its inflammatory cells. In the lower salivary glands various superficial epithelial proliferations, such as epidermoid papillomas or carcinomas, as well as submucosal fibrosis, fibrous hyperplasia, may obstruct the lumen of the minor duct or compress the extralobulillary ducts exiting the gland. The flanges of the dental prosthesis, can compress some salivary glands causing a sialoadenitis, as well as neoplasias. One of the main causes of Sialoadenitis is the radiation therapy used in the treatment of head and neck. Clinically it presents as painless mass of slow growth accompanied sometimes pain of swallowing. The following case is an 80-year-old male patient, born and resident in Baños, complete upper education, blood type O Rh (+) with a personal pathological history of prostate cancer 6 years ago, hypertension 25 years ago With treatment, dental extraction 1 month ago, family history hypertensive mother, father hypertensive + diabetic, surgical history cholecystectomy 10 years ago, admitted to the emergency service of the Hospital IESS Ambato for presenting 1 month after extraction of dyspnea from medium-effort efforts Which is exacerbated to ambulation, pain in the left maxillary region, punctate type, moderate intensity, in addition to progressive edema, cold, in the left maxillary region, with odynophagia, physical examination TA: 135/85, CF: 89, FR: 21, SATO2: 86%, FIO2: 27% general algetic, asthenic appearance; Generalized pallor skin; In face cold edema, it is felt hard mass of approximately 3 x 4 cm, non-mobile, with regular borders, and painful to digitropression in the left maxillary region; Hypofonética mouth; Erythematous oropharynx; Neck cervical lymphadenopathy; Decreased expandability; Lungs decreased vesicular murmur, crepitans spread in both lung fields, so it was decided to enter the service of Internal Medicine with diagnosis of left submaxillary abscess vs. sialoadenitis + chronic obstructive pulmonary disease (COPD) + hypertension + prostate cancer . Therefore, it is decided to carry out multiple complementary examinations and necessary procedures. Thus, according to the symptoms and results of the examinations performed, several pathologies have been ruled out, resulting in a final result after histopathological report chronic sclerosing sialadenitis + arterial hypertension + prostate cancer.