A Case of Internal Jugular Vein Thrombophlebitis with Deep Neck Abscess Treated by Debridement of Internal Jugular Vein and Vacuum-assisted Closure Therapy

Abstract

Internal jugular vein (IJV) thrombophlebitis is a rare complication of deep neck abscess. A 55-year-old male was diagnosed with retropharyngeal and mediastinal abscesses. In spite of treatment with surgical drainage and antibiotics, his deep neck abscess was aggravated and there was newly developed diffuse necrosis of the right IJV. We performed surgical drainage again with closure of the fistula on the posterior pharyngeal wall caused by the neck abscess and applied vacuum-assisted closure therapy. However, the patient’s condition deteriorated. Therefore, we decided to perform debridement of the necrotic tissue in the right IJV and ligate the vein. After that, intravenous antibiotics and vacuum-assisted closure therapy were continued and the patient was successfully treated. In case of deep neck abscess accompanied by IJV thrombophlebitis, ligation of the IJV and removal of the causative necrotic tissue would be effective. (J Clinical Otolaryngol 2018;29:104-108)