Idiopathic Bilateral Internal Jugular Vein Thrombosis Diagnosed by Point-of-Care Ultrasound.

Victor Aquino-Jose,Jennifer Johnson,Tina Dulani

doi:10.5811/cpcem.2019.11.44855

Abstract

Internal jugular vein (IJV) thrombosis is an unusual condition, especially when it develops bilaterally. This is a case of bilateral IJV thrombosis in a 77-year old female who presented to the emergency department with neck and arm swelling after discontinuing apixaban and undergoing an oropharyngeal procedure. The diagnosis of bilateral IJV thrombosis was made with the use of point-of-care ultrasound to evaluate bilateral jugular vein distention and bilateral upper extremity pitting edema found on her physical examination.

Highlights

Internal jugular vein (IJV) thrombosis is an unusual condition, especially when it develops bilaterally. This is a case of bilateral IJV thrombosis in a 77-year old female who presented to the emergency department with neck and arm swelling after discontinuing apixaban and undergoing an oropharyngeal procedure
Previous studies indicate that it usually occurs in patients with a history of malignancy, oropharyngeal infections, or deep vein thrombosis.[1,2]
D) Color doppler of the left internal jugular vein thrombus showing partial occlusion of the lumen seen on transverse view

Summary

Images in Emergency Medicine

Idiopathic Bilateral Internal Jugular Vein Thrombosis Diagnosed by Point-of-Care Ultrasound. Internal jugular vein (IJV) thrombosis is an unusual condition, especially when it develops bilaterally This is a case of bilateral IJV thrombosis in a 77-year old female who presented to the emergency department with neck and arm swelling after discontinuing apixaban and undergoing an oropharyngeal procedure. CASE PRESENTATION A 77-year-old female with a history of atrial fibrillation currently taking apixaban presented to the emergency department (ED) with swelling of her neck and arms for the past seven days. Two weeks prior, she underwent an embolization of a greater palatine pseudoaneurysm, for which she stopped taking apixaban. The patient was started on anticoagulation and admitted to the Intensive Care Unit (ICU) for monitoring due to significant thrombus burden

DISCUSSION

Idiopathic Bilateral Internal Jugular Vein Thrombosis Diagnosed by POCUS