Abstract

External jugular vein is the superficial vein of the neck and is prone to variations. Multiple internal jugular veins are incidental findings that present as a duplication or fenestration. We encountered a unilateral fenestrated internal jugular vein and a bilateral variation in the course of external jugular vein, during a cadaveric dissection. The external jugular vein, after its formation, crossed the sternocleidomastoid muscle and pierced the investing cervical fascia of the posterior triangle. It traversed deep to the inferior belly of omohyoid muscle to enter the subclavian triangle and terminated by draining into the subclavian vein on the left side, and at the angle between the internal jugular vein and the subclavian vein on the right side. The fenestrated internal jugular vein on the left side divided into a small medial and large lateral division which reunited at the level of the tendon of omohyoid muscle and drained into the subclavian vein. Only the medial division of the internal jugular vein received tributaries in the neck. Awareness of the multiple variations of the jugular veins would be valuable during surgical approaches to the neck. Present report aims to be useful for vascular surgeons, radiologists, and intensivists as well.

Highlights

  • External jugular vein (EJV) is the superficial vein of the neck formed by the union of the posterior division of the retromandibular vein with the posterior auricular vein, near the angle of mandible

  • At the root of the neck, it pierces the deep fascia to drain into the subclavian vein.[1]

  • Both the divisions of Internal jugular vein (IJV) reunited at the level of the tendon of omohyoid muscle and drained into the subclavian vein

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Summary

Introduction

External jugular vein (EJV) is the superficial vein of the neck formed by the union of the posterior division of the retromandibular vein with the posterior auricular vein, near the angle of mandible. During routine dissection in a 50-year-old male cadaver for undergraduate teaching program, variation in the external and internal jugular veins was encountered On both the sides of neck, union of the posterior division of retromandibular and posterior auricular veins formed the EJVs. The left EJV, after its formation at the apex of parotid gland, crossed the middle third of sternocleidomastoid muscle and pierced the deep fascia in the occipital triangle. Lateral division of IJV which was larger in caliber did not receive any tributaries in the neck Both the divisions of IJV reunited at the level of the tendon of omohyoid muscle and drained into the subclavian vein. In accordance with the classification by Nayak et al, the present case falls under type A pattern

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