A Rare Cause of the Emergency Department Visit: Internal Jugular Vein Thrombosis

Abstract

Introduction Detection of the internal jugular vein thrombus (IJVT) in the Emergency Department with bedside ultrasonography is not common. Case Report A 43 years old male patient was admitted to our emergency department with the complaint of pain, swelling and redness on the left side of the neck, which was noticed after chemotherapy 1 day ago. The swelling and redness of the hand, starting from the left clavicle and extending to the corner of the left mandible, were detected in the physical examination of the patient. The patient underwent bedside ultrasonography imaging by the emergency medicine specialist. Ultrasonography examination of the patient was performed with 5-12 MHz linear probe. After visualization of the vascular structures carotid, vascular structures were observed in the sagittal and longitudinal plane by gradual compression. Hyper echoic thrombus was seen in the incompressible internal jugular vein. Conclusion IJVT can lead to complications such as pulmonary embolism, septic embolism, cerebral venous thrombosis. These complications may decrease with early diagnosis and treatment. It is a rare condition in IJVT Emergency Services. The increasing use of bedside ultrasonography by emergency physicians will prevent possible complications that will enable these patients to be easily diagnosed and successful treatments in recent years.

Keywords

• Doppler Ultrasound Imaging
• Emergency Department
• Jugular Vein
• Venous Thrombosis

References

1. 1. Gritzmann N, Hollerweger A, Macheiner P, et al. Sonography of soft tissue masses of the neck. J Clin Ultrasound 2002;30:356–373.
2. 2. Hahn J, Nordmann-Kleiner M, Hoffmann TK, Greve J. Thrombosis of the internal jugular vein in the ENT-department-Prevalence, causes and therapy: A retrospective analysis. Auris Nasus Larynx 2019;46:624-629. doi: 10.1016/j.anl.2018.11.009.
3. 3. Bilici M, Pehlivan Y, Kimyon G, Kisacik B. Internal jugular vein thrombosis in Behcet’s disease: a rare complication. BMJ Case Rep 2014. doi: 10.1136/bcr-2013-200261.
4. 4.Schubert AD, Hotz MA, Caversaccio MD, Arnold A. Septic thrombosis of the internal jugular vein: Lemierre’s syndrome revisited. Laryngoscope 2015;125:863–8. doi: 10.1002/lary.24995.
5. 5.Boedeker CC, Ridder GJ, Weerda N, Maier W, Klenzner T, Schipper J. Etiology and therapy of the internal jugular vein thrombosis. Laryngorhinootologie 2004;83:743–9. doi: 10.1055/s-2004-825749.
6. 6.Heit JA, O Fallon WM, Petterson TM, et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population based study. Arch Intern Med 162:1245. doi: 10.1001/archinte. 2002;162.11.1245.
7. 7.Ascher E, Salles-Cunha S, Hingorani A. Morbidity and mortality associated with internal jugular vein thromboses. Vasc Endovascular Surg 2005;39:335-9. doi: 10.1177/153857440503900405.
8. 8.Gbaguidi X, Janvresse A, Benichou J, Cailleux N, Levesque H, Marie I. Internal jugular vein thrombosis: outcome and risk factors. QJM 2011;104:209–19. doi: 10.1093/qjmed/hcq179.

9. 9.Schubert AD, Hotz MA, Caversaccio MD, Arnold A. Septic thrombosis of the internal jugular vein: Lemierre’s syndrome revisited. Laryngoscope 2015;125:863–8. doi: 10.1002/lary.24995.
10. 10.Girard DE, Reuler JB, Mayer BS, Nardone DA, Jendrzejewski J. Cerebral venous sinus thrombosis due to indwelling transvenous pacemaker catheter. Arch Neurol 1980;37:113-114. doi: 10.1001/archneur.1980.00500510071015.