Dilatation Of Internal Jugular Vein Research Articles

Internal jugular phlebectasia: A systematic review.

Background:Internal jugular phlebectasia (IJP), the abnormal dilatation of internal jugular vein, is generally considered a benign anomaly. However, because IJP is uncommon, little is known about its natural history, and currently, no consensus on the best treatment modality is available.Methods:The purpose of this article is to conduct a systematic review of available literature on recently reported IJP cases to understand the main characteristics of IJP and its most frequent therapeutic approaches. Following the preferred reporting items for systematic reviews and meta-analyses guidelines, literature search for IJP cases was conducted in the COCHRANE, PUBMED, EBSCOHOST, SCOPUS, OVID, and SCIELO databases.Results:A total of 97 original articles were found, with a total of 247 IJP cases reported including both pediatric and adult patients.Conclusions:To the best of our knowledge, this study is the largest systematic review analyzing all the reported cases of IJP. IJP is considered by most authors as a benign abnormality that predominantly affects the right jugular vein. It is most commonly diagnosed in children. At present, conservative treatment is preferred for pediatric but not for adult patients. Multicenter randomized prospective studies are required to further understand this rare anomaly.

Jugular phlebectasia: clinical scenario in India.

Jugular phlebectasia is fusiform dilatation of internal jugular vein seen in childrens. It usually occurs in children but can occur at any age. It usually presents as unilateral swelling in the neck found during coughing and shouting. It is usually asymptomatic, so it is often ignored or misdiagnosed. Differential diagnosis include laryngocele, cavernous hemangioma, cystic hygroma, branchial cyst. Treatment is usually conservative as complications like thrombosis and horners syndrome are very rare. Non invasive investigations like Doppler sonogram and are usually done to diagnose this condition. We report two cases of jugular phlebectasia, who presented to our out patient department with history of swelling in the right side of neck which increases on crying and shouting. Doppler sonogram and ultrasound was done to diagnose the condition. There seems be lack of knowledge among medical fraternity in various specialities. So a questionnaire was prepared to assess the knowledge among resident doctors, general practitioners, Otorhinolaryngologists, paediatricians. Questionnaire was posted in social networking sites and the feedback was obtained. Out of the 150 interns in our hospital, only one (0.66%) was able to explain about the condition. In general practitioners group containing 369 respondents, only 4 (1.08%) knew the condition and have seen patients. A pediatricians group containing 312 respondents only 23 (7.37%) pediatricians knew the condition, 289 (92.62%) persons had no idea about the treatment. Otorhinolaryngologists group containing 328 respondents. 21 (6.40%) knew the condition, 293 (89.3%) have no idea. The Chi square test shows that the specialty of the respondent like pediatrician and ENT practitioner have more knowledge than the other for jugular phlebectasia at p<0.0001.

Internal Jugular Phlebectasia in a Patient with Facial Trauma

Internal jugular phlebectasia (IJP) is defined as a fusiform dilatation of the internal jugular vein without tortuosity [1]. IJP is diagnosed on physical examination and Doppler ultrasonography. However, it rarely presents symptoms or complications. It is commonly recommended that regular monitoring of its clinical course be performed, and sometimes surgery is performed for cosmetic purposes [2-5]. We report a case of a 40-year-old woman with facial trauma with a review of the literature. A 40-year-old woman visited the Department of Emergency Medicine with chief complaints of facial laceration and complex fracture of the right zygomatic bone after a motorcycle traffic accident. The patient had no comorbidities other than iron deficiency anemia that was being controlled with an oral iron supplement. Because the patient presented right neck swelling, Doppler ultrasonography was performed to rule out a diagnosis of delayed rupture of the cervical vessels. However, it revealed no definite abnormalities other than the dilatation of the right internal jugular vein (Fig. 1). After open reduction and internal fixation of the zygomatic fracture, a physical examination was performed. This showed an enlargement of the neck swelling during a Valsalva maneuver. We tried to find any causative structural lesions such as a cervical or laryngeal mass, but computed tomography (CT) scans showed no definite structural abnormalities (Figs. 2,​,3).3). The patient had no symptoms and refused surgery for follow-up, the patient presented with no complications. Fig. 1 Ultrasonography of the right neck. The yellow arrow shows a marked dilatation of the right internal jugular vein without abnormalities of the adjacent structures. Fig. 2 Clinical photographs taken (A) at rest and (B) during the Valsalva maneuver. The yellow arrow shows the right neck swelling during the Valsalva maneuver. Fig. 3 (A) Axial and (B) coronal views of contrast-enhanced computed tomography scans of the neck. The yellow arrows show a marked dilatation of the right internal jugular vein without other abnormalities. IJP is a rare condition and its epidemiologic features have not been well documented. In recent years, its incidence has increased. This is attributable to an increased number of diagnoses of subclinical cases because of advancement of diagnostic imaging modalities and increased frequency of laryngeal and cervical surgery [1,2]. Two hypotheses have been proposed to explain the etiology of IJP: The first is the elevated pressure in the internal jugular vein and the second is the congenital defect of the venous wall. If there is a mediastinal or cervical mass, it could disturb the venous drainage or cause regurgitation of venous flow. This eventually leads to the increased hydrostatic pressure and dilatation of the vessel. Second, if there is a congenital defect of the venous wall, this could also cause IJP. Surgical specimens have shown a loss of elastic tissue, thinning of the venous wall, fibrosis, and a decrease or absence of the smooth muscle layer [1,2]. IJP can be diagnosed by flow in Doppler ultrasonography and dilation during the Valsalva maneuver. In addition, any causative structural lesions should be ruled out on CT scans [2]. Complications that occur in rare cases include progression, thrombosis, and Horner's syndrome. The chief complaint of patients is cosmetic concerns [1-4]. Clinical surveillance is usually recommended when there are no symptoms or complications. In these cases, however, surgery is a possible treatment option. Conventional surgical procedures consist of ligation of the internal jugular vein through a transcutaneous cervical approach or transaxillary approach [3,4]. Venoplasty or anastomosis after resection of the affected lesion has been performed successfully to preserve the physiologic blood flow of the cervical vessels, especially in bilateral cases [5]. In the current case, we decided to follow-up with the patient on a monthly basis, not only because there were no symptoms or complications, but also because the radiologic study revealed only the dilatation of the internal jugular vein without any causative structural lesions. In addition, the patient refused to undergo cosmetic surgery. In evaluating patients with trauma who experience neck swelling, clinicians should consider making a differential diagnosis of various conditions from simple contusion to life-threatening ones including pseudoaneurysm or a delayed rupture of the cervical vessels. These life-threatening vessel injuries can be confirmed by angiography, which should be accompanied by emergency intervention or surgery. Although IJP is a rare condition, when making a differential diagnosis of neck swelling in patients with trauma, clinicians should refrain from unnecessary evaluations by performing a physical examination and routine radiography to conserve time and money. We experienced a rare case of IJP in a patient with trauma. Clinicians should be aware of IJP as a candidate condition of the differential diagnosis of neck swelling in trauma patients.

Phlebectasia of Internal Jugular Vein

Internal jugular phlebectasia (IJP) is a rare disease in which there is a fusiform dilatation of internal jugular vein, usually presenting as a neck mass in children. Accurate diagnosis from careful history, physical examination, and radiological study can be made. We report a 12-year-old boy with history of swelling appearing on the right side of the neck only on straining, coughing, or during a Valsalva maneuver. Diagnosis of right IJP was made. Exploration and wrapping the dilated segment in an 8-mm-diameter polytetrafluoroethylene tube graft was done. Because of its rarity, this entity is frequently ignored or misdiagnosed. This case report intends to stress the importance of keeping IJP as differential diagnosis while dealing with such a swelling to avoid invasive investigations and inappropriate treatment.

Internal jugular phlebectasia

Varicose veins are a common venous anomaly, where as phlebeetasia is rare. It is an abnormal dilation of an isolated vein. Any vein may be affected and the condition is usually asymptomatic [1]. Internal jugular phlebeetasia (IJP) is abnormal dilation of internal jugular vein (IJV). This report aims at clinical awareness of the condition.