Jugular vein thrombosis

Jugular vein thrombosis
Other names: Internal jugular vein thrombosis
A post-operative internal jugular vein thrombosis on the person's right
SymptomsNone, neck swelling[1]
ComplicationsPulmonary embolism[1]
TypesLemierre syndrome (due to infection)[1]
Risk factorsCancer, central venous catheter, factor V Leiden[1]
Diagnostic methodUltrasound, CT scan[1]
Differential diagnosisSuperior vena cava syndrome, mediastinitis, cellulitis[1]
TreatmentGenerally anticoagulation[1]
Frequency7.5% people with both a central venous catheter and cancer[1]

Jugular vein thrombosis is when a blood clot develops within the internal jugular vein (IJV).[1] While many have few or no symptoms, others develop swelling, tenderness, and redness of the neck.[1] A hard area along the vein may also be felt.[1] If infection occurs other symptoms may include fever and headache.[1] Complications may include pulmonary embolism.[1][2]

The most common causes are cancer and a central venous catheter.[1] Other risk factors include factor V Leiden, injury to the neck, ovarian hyperstimulation syndrome (OHSS), and intravenous drug use.[1] Cases that occur as a result of infection are known as Lemierre syndrome.[1] Diagnosis may be suspected based on the D-dimer and confirmed by ultrasound or CT scan.[1]

Treatment in those with a low risk of bleeding is generally with anticoagulation for 4 to 12 weeks. Medications used may include heparin and warfarin or a factor Xa inhibitor.[1] If possible the central venous catheter should be removed.[1] No specific treatment may be an option in those without symptoms.[1] Thrombolysis or surgery is rarely recommended.[1]

Jugular vein thrombosis affected 7.5% people with both a central venous catheter and cancer.[1] The risk of death in those affected is about 44% and is greater in those with other health problems.[1] Infected cases of jugular vein thrombosis were first described in 1936.[3]

Signs and symptoms

Swelling along the anterior border of right sternocleidomastoid muscle and distension of the right jugular vein (arrow).

While many have few or no symptoms, others develop swelling, tenderness, and redness of the neck.[1] A hard area along the vein may also be felt.[1] If infection occurs other symptoms may include fever and headache.[1] Complications may include pulmonary embolism.[1]

Diagnosis

Thrombus visualized within the right internal jugular vein (RIJV; arrow). The vessel could not be compressed.

Diagnosis may be suspected based on the D-dimer and confirmed by ultrasound or CT scan.[1]

Other animals

Other animals may be affected including horses.[4]

Refences

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Lee, Y; Siddiqui, WJ (January 2022). "Internal Jugular Vein Thrombosis". PMID 31082155. {{cite journal}}: Cite journal requires |journal= (help)
  2. ↑ Reinus, William R. (21 October 2013). Clinician's Guide to Diagnostic Imaging. Springer Science & Business Media. p. 166. ISBN 978-1-4614-8769-2.
  3. ↑ Caplivski, Daniel; Scheld, W. Michael (2 February 2012). Consultations in Infectious Disease: A Case Based Approach to Diagnosis and Management. Oxford University Press. p. 118. ISBN 978-0-19-990910-0. Archived from the original on 17 October 2022. Retrieved 16 October 2022.
  4. ↑ Sprayberry, Kim A. (2009). Current Therapy in Equine Medicine. Elsevier Health Sciences. p. 230. ISBN 978-1-4160-5475-7.
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