• Occurs from outflow obstruction by a stone or calculus in the salivary gland or duct
  • Submandibular location most commonly
    • More viscous secretions and runs an uphill course

Clinical Features

  • Xerostomia (dry mouth) along
  • Increasing swelling and pain during mealtime

Differential Diagnosis

Facial Swelling


  • Pass spontaneously
  • Start on sialogogues (e.g., sour lozenges, lemon juice), which stimulate salivary secretions and help expel the stone
  • Palpable stones may also be “milked” from the duct
    • Stroking in a posterior to anterior direction.
  • If infected, consider Amoxicillin/Clavulanate or Clindamycin


  • Outpatient

Also See


  • Knoop The Atlas of Emergency Medicine, pg 124
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