Rare encounter: facial vein thrombosis and thrombophlebitis as a complication of acute submandibular sialadenitis

BMJ Case Rep. 2024 Feb 13;17(2):e259423. doi: 10.1136/bcr-2023-259423.

Abstract

Thrombosis and thrombophlebitis of the facial vein represent exceptionally rare diagnoses, particularly when occurring as complications of acute sialadenitis of the submandibular gland. This case report details the experience of a middle-aged man initially presenting at a tertiary care ear, nose and throat department with right submandibular gland sialadenitis. Despite initiating outpatient treatment involving oral antibiotics and sialagogues, the patient returned after a week with persistent and worsening pain, accompanied by swelling of the right submandibular gland and cheek. Using ultrasound, the accurate diagnosis was promptly identified, revealing thrombosis in the facial vein.The patient underwent a comprehensive treatment regimen involving anticoagulation and intravenous antibiotics. With a subsequent reduction in pain and swelling, the patient was discharged, continuing oral anticoagulation and antibiotics. Outpatient follow-up revealed a complete recovery 3 weeks later. This case underscores the importance of timely and precise diagnostic measures in managing rare complications associated with sialadenitis.

Keywords: Head and neck surgery; Otolaryngology / ENT; Thrombosis; Ultrasonography.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Pain / complications
  • Sialadenitis* / diagnosis
  • Sialadenitis* / etiology
  • Submandibular Gland / diagnostic imaging
  • Thrombophlebitis* / diagnosis
  • Thrombophlebitis* / drug therapy
  • Thrombophlebitis* / etiology
  • Venous Thrombosis* / complications

Substances

  • Anti-Bacterial Agents
  • Anticoagulants