Unilateral ‘Sausaging’ of the Stensen's Duct

Abstract

A 35-year-old white lady was referred to Kyiv Regional Clinical Hospital for the sialography due to several year history of recurrent swelling of the right parotid gland. A multi-slice computed tomographic sialography of the both parotid glands was performed. A 1-minute postcontrast axial scan shows a dilated right Stensen`s duct with multiple strictures (arrowheads) and dilated intraglandular branches. ‘String of sausages’ appearance represents the ducts` inflammation and terms sialodochitis. But the signs of sialodochitis can be found in several pathologic conditions, like chronic recurrent parotitis and ‘sialodochitis fibrinosa’ (synonym: ‘Kussmaul disease’) and its similar terms ‘eosinophilic sialodochitis’, ‘allergic sialodochitis’. Those terms and others (‘sialodochitis with eosinophilic inflammation’ and ‘idiopathic eosinophilic parotitis’) can be used depending on the countries. For proving and establishing a diagnosis of eosinophilic sialodochitis a cytologic analysis of mucus plugs and ultrasound-guided core needle biopsy are needed and those condition habitually represents bilateral involvement of the parotid and submandibular glands. Unilateral sausaging of the main parotid duct is common for chronic recurrent parotitis in adults. While in children a bilateral intraglandular ducts dilatation is usual with no signs of dilatation of the Stensen`s ducts.