CLINICAL CASES   

Giornale Italiano di Chirurgia Vascolare 2000 June;7(2):135-46

Copyright © 2001 EDIZIONI MINERVA MEDICA

language: English, Italian

Internal jugular vein thrombosis with no evident causes. A case report

Bacciu P. P., Marongiu G. M., Canu G. L.

From the Department of Vascular Surgery (Head: Prof. P. P. Bacciu) University of Sassari, Italy

Internal jugular vein thrombosis (­IJVT) is not ­very com­mon ­today, but was ­well ­known in the pre-anti­bi­o­tic era in con­com­i­tance ­with ­severe infec­tions of the ­head and ­neck. At ­present, the ­most com­mon ­cause of ­IJVT is the ­ever ­more fre­quent use of endo­ve­nous ­drugs, espe­cial­ly ­when ­infused ­through a cen­tral (sub­cla­vian, exter­nal jug­u­lar) ­vein. In addi­tion, the hyper­stim­u­la­tion of the ovar­ies in in ­vitro fer­til­isa­tion has led to an ­ever high­er num­ber of ­IJVT cas­es ­being report­ed in the lit­er­a­ture. Other ­major caus­es of ­this par­tic­u­lar throm­bo­sis are: com­pres­sions and/or infil­tra­tions by pri­mary or sec­on­dary ­tumours; ­local sur­gi­cal manip­u­la­tions, ­local or region­al sep­sis; the exten­sion to the jug­u­lars of ­venous throm­bos­es on oth­er ­sites (the sinus­es of the ­dura mat­er). The symp­toms ­vary con­sid­er­ably but are like­ly to ­include a pal­pa­ble swell­ing of the ­neck ­that is pain­ful ­either spon­ta­ne­ous­ly or if sub­ject­ed to pres­sure, ­with a ­hard, elas­tic con­sis­ten­cy and with­out any ­sign of inflam­ma­tion or ade­nop­a­thy. The con­di­tion is fair­ly eas­i­ly diag­nosed in the pres­ence of a cen­tral ­venous cath­e­ter, an inju­ry, a ­tumour or a ­venous throm­bo­sis of a ­dura mat­er ­sinus. However ­there are total­ly asymp­to­mat­ic ­forms ­which ­will ­only be diag­nosed by acci­dent in the ­course of oth­er exam­ina­tions. The ­case report­ed is of par­tic­u­lar inter­est ­since it was encoun­tered in a ­patient ­with no ­known aet­io­log­i­cal fac­tors and no ­test ­results indic­a­tive of the con­di­tion (the ­only indi­ca­tor ­being the ­patient’s treat­ment ­with ­oral oes­trop­ro­ges­tins). The ­case encoun­tered ­offers the oppor­tu­nity for a ­review of the lit­er­a­ture on ­this con­di­tion.