Obstructive Sialolithiasis
in buffalo and its management
V.B.
Joshi, S.P. Tyagi and Avinash
Sharma
Sub-divisional
ABSTRACT
A
nine years old female buffalo was presented in the clinics with a history of
the development of two hard swellings on right cheek followed by another larger
diffuse soft swelling caudal to that since last 9 months. The softer swelling
gradually increased in size and eventually ruptured one-month back leading to
continuous leakage of transparent viscous fluid since then. On clinical
examination, the condition was diagnosed as salivary fistula resulting due to
the complete obstruction in the flow of saliva through the Stenson’s
duct by sialoliths. Sialolithiasis
has been reported in a number of animal species but not in buffaloes so far.
Therefore, this condition and its successful surgical treatment are described
in the present communication.
Sialoliths or salivary calculi may form in the salivary
glands or salivary ducts of
The animals.
The sialoliths developing in the salivary ducts of
the animal may eventually obliterate the passage of saliva. This may either
lead to formation of a salivary cyst and then a fistula or may cause salivary
gland atrophy. A case of a buffalo having salivary fistula due to sialoliths is presented in the present communication. Sialolithiasis has been reported in a number of animal
species but not in buffaloes so far. Therefore, this condition and its successful
surgical treatment are described.
Case
history and clinical examination:
A
nine years old female buffalo was reported with the history of developing two
hard swellings on right cheek which were gradually increasing in size since
last 9 months. After a few months, another larger diffuse soft swelling started
developing distal to them and gradually increased in size leading to its
eventual rupture one month back releasing a clear transparent viscous fluid.
Continuous leakage of this fluid from the opening was being observed since
then. The clinical examination of the animal revealed the presence of two
well-defined hard nodular swellings at the course of Stenson’s
duct over massatter muscle on right cheek. The saliva
(pH 8.5) was observed leaking continuously through a small fistula caudo-ventral to these swellings (Fig. 1). Exploration of
fistula revealed marked enlargement and complete obliteration of the lumen of Stenson’s duct by two hard intra-luminal mass rostral to fistulous opening. The case was diagnosed as
salivary fistula resulting due to complete obliteration of Stenson’s
duct by sialoliths. The surgical intervention for
removal of calculi and repair of fistula was contemplated.
Anaesthetic and surgical management:
The
animal was routinely prepared for aseptic surgery. The animal was sedated with 5 ml Triflupromazine (Siquil, Sarabhai. India Ltd.) administered
intramuscularly 30 minutes prior to surgery. Local analgesia of surgical site
was achieved by subcutaneous infiltration of 10 ml of 2% Lignocaine
HCL (Xylocaine, Astra-IDL).
A 5-cm long linear incision was given on skin directly over the hard swellings.
The Stenson’s duct was dissected carefully taking
care to avoid accompanying veins and arteries (Fig. 2) The
culculi were exposed by an incision on the duct and
these were removed with the help of an Allis tissue forceps. The duct was lavaged with Ringer’s solution and its patency
was confirmed by catheterization rostrally, Careful
dissection, debridement and excision of superfluous
part of the wall of fistula and duct were then done followed by lavaging with Ringer’s solution. The fistulous opening of
the duct was then closed with chromic catgut sutures applied in a simple
continuous manner. The first suture line was buried under the overlying fascia
again by catgut sutures. The skin was closed routinely with silk sutures in an
interrupted mattress pattern. The animal was given Inj.
Streptopenicillin (Dicrysticin,
Sarabhai India Ltd.) 2.5 gm I/M and Inj. Diclofenec sod. (Zobid, Sarabhai India Ltd.) 15 ml
I/M daily for 7 days besides regular antiseptic dressing of wound post
operatively. The surgical wound eventually healed normally and no leakage of
saliva was seen thereafter. No recurrence of the condition was reported till
six months after the surgery.
DISCUSSION
The
occurrence of sialoliths or salivary calculi has been
reported in different kinds of animals such as dog (Bartels, 1978), cattle (Ali
et al, 1978), monkey (Ensley et al, 1981), donkey (Misk
et al, 1984), horse (Bouayad et al, 1991) camel (Barvalia et al, 1992), chimpanzee (Orkin
et al, 1990) etc. These are seen more often in horses than in other species (Hofmeyr, 1988). Sialoliths form
in a duct or in the salivary gland itself, generally as a result of chronic
inflammation, which provides desquamated cells or consolidated exudates as a
minute nidus upon which calcium salts precipitate (Orkin et al, 1990). Small foreign bodies entering the ostium of salivary duct may also initiate the precipitation
of salts (Hofmeyr 1988; Baskett
et al, 1995). The cross sectioning of the sialoliths
in the present case revealed the presence of hay straw in the centre (Fig. 4).
This suggests that the hay straw might have accidentally entered the salivary
duct probably during rumination and acted as nidus
for the deposition of salivary salts. The continuous
Deposition of salts may result in formation of very large sized calculi
of various shapes sometimes up to several centimeters in length and diameter
(Jones et al, 1997). In the present case also, one calculus was almost
cylindrical (approximately 2.5 cm x 2.0 cm x 2.0 cm) and weighing 10.14 gm
whereas, another calculus occupying rostral position
in the duct was almost rounded (diameter 2.0 cm) and weighed 6.77 gm (Fig. 3).
The main component of sialoliths in the present case
was identified to be calcium carbonate along with traces of magnesium and
phosphate. Calcium carbonate is routinely identified in cases of sialoliths in other species of animals also (Hofmeyr, 1988). Larger calculi obliterate the salivary
ducts that may result in to atrophy of associated salivary gland. However,
generally before this process is complete, a cyst may form in the obstructed
duct due to the dilating effect of the entrapped secretions. A salivary fistula
occasionally forms when an injury creates an opening from the duct to the
outside of the body (Orkin et al, 1990). The early
surgical intervention is must for the treatment of this condition to save the
affected salivary gland from atrophy.
The
perusal of the literature failed to reveal any report about the occurrence of sialoliths in buffaloes so far. Therefore this case is
reported to record the occurrence of sialoliths in
buffaloes in
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Fig. 1. Nodular swelling at the course of dilated Stenson’s
duct with caudoventral fistula
Fig. 2. Dissected Stenson’s duct with sialolith in its lumen
Fig. 3. Sialotilts removed from the Stenson’s duct
Fig. 4. Cross section of sialoliths showing hay straw
in the centre