Evidence Based Management of Spontaneous Internal Jugular Vein Thrombosis: A Literature Review

Abstract

Internal Jugular Vein (IJV) thrombosis is a rare but potentially fatal condition. First described in 1912 as a complication of peritonsillar abscess it is now known to have a varied aetiology. The leading cause of IJV thrombosis is the use of the IJV for venous access and central venous catheterisation. We present a comprehensive literature review of idiopathic internal jugular vein thrombosis and also present our management experience of this rare condition in an otherwise healthy 60 year old woman. The patient was admitted with a 5 day history of an enlarging right sided neck swelling that was initially associated with redness and pain. Clinically she was stable but there was a tender, soft, diffuse swelling along the length of the right sternomastoid muscle. The overlying skin was mildly erythematous. The ultrasound scan showed occlusive thrombosis of right IJV. Blood cultures, a chest x-ray and computed tomography of chest were all normal. The patient was put on warfarin for 6 months. All the subsequent investigations were normal. Or literature review shows that IJV thrombosis is an important differential diagnosis in a neck swelling. Along with various other factors, it can also occur as a complication of head and neck malignancy, and rarely can be its first manifestation. On other occasions a specific aetiology is never found. Multidisciplinary team approach is required to manage the patient efficiently and the patient needs to be investigated thoroughly to rule out a pathological cause of IJV thrombosis. Keywords: