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Idiopathic Bilateral External Jugular Vein Thrombosis.

Hindi Z, Fadhel E - Am J Case Rep (2015)

Bottom Line: Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy.The patient was eventually discharged on warfarin.While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Hamad Medical Corporation, Doha, Qatar.

ABSTRACT

Background: Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchow's triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy.

Case report: This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely.

Conclusions: Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy.

No MeSH data available.


Related in: MedlinePlus

Ultrasound Doppler of the right external jugular vein showing filling defect suggestive of thrombosis. Right proximal external jugular vein (A). Right middle external jugular vein (B). Right distal external jugular vein (C).
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f1-amjcaserep-16-554: Ultrasound Doppler of the right external jugular vein showing filling defect suggestive of thrombosis. Right proximal external jugular vein (A). Right middle external jugular vein (B). Right distal external jugular vein (C).

Mentions: Initial lab investigations, including complete blood count, basic metabolic panel, liver function tests, and kidney function parameters, were within normal limits. Doppler ultrasound of the neck revealed non-compressible bilateral external jugular veins without a flow, suggesting thrombosis of external jugular veins. The internal jugular veins on both sides were patent (Figures 1A–C, 2A–C).


Idiopathic Bilateral External Jugular Vein Thrombosis.

Hindi Z, Fadhel E - Am J Case Rep (2015)

Ultrasound Doppler of the right external jugular vein showing filling defect suggestive of thrombosis. Right proximal external jugular vein (A). Right middle external jugular vein (B). Right distal external jugular vein (C).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4554332&req=5

f1-amjcaserep-16-554: Ultrasound Doppler of the right external jugular vein showing filling defect suggestive of thrombosis. Right proximal external jugular vein (A). Right middle external jugular vein (B). Right distal external jugular vein (C).
Mentions: Initial lab investigations, including complete blood count, basic metabolic panel, liver function tests, and kidney function parameters, were within normal limits. Doppler ultrasound of the neck revealed non-compressible bilateral external jugular veins without a flow, suggesting thrombosis of external jugular veins. The internal jugular veins on both sides were patent (Figures 1A–C, 2A–C).

Bottom Line: Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy.The patient was eventually discharged on warfarin.While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Hamad Medical Corporation, Doha, Qatar.

ABSTRACT

Background: Vein thrombosis is mainly determined by 3 factors, which constitute a triad called Virchow's triad: hypercoagulability, stasis, and endothelial injury. Venous thrombosis commonly occurs in the lower extremities since most of the blood resides there and flows against gravity. The veins of the lower extremities are dependent on intact valves and fully functional leg muscles. However, in case of valvular incompetency or muscular weakness, thrombosis and blood stasis will occur as a result. In contrast, the veins of the neck, specially the jugulars, have distensible walls which allow flexibility during respiration. In addition, the blood directly flows downward towards the heart. Nevertheless, many case reports mentioned the thrombosis of internal jugular veins and external jugular veins with identified risk factors. Jugular vein thrombosis has previously been associated in the literature with a variety of medical conditions, including malignancy.

Case report: This report is of a case of idiopathic bilateral external jugular vein thrombosis in a 21 year-old male construction worker of Southeast Asian origin with no previous medical history who presented with bilateral facial puffiness of gradual onset over 1 month. Doppler ultrasound and computed tomography were used in the diagnosis. Further work-up showed no evidence of infection or neoplasia. The patient was eventually discharged on warfarin. The patient was assessed after 6 months and his symptoms had resolved completely.

Conclusions: Bilateral idiopathic external jugular veins thrombosis is extremely rare and can be an indicator of early malignancy or hidden infection. While previous reports in the literature have associated jugular vein thrombosis with malignancy, the present case shows that external jugular vein thrombosis can also be found in persons without malignancy.

No MeSH data available.


Related in: MedlinePlus