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

Shakeel, Muhammad

doi:10.15406/joentr.2015.02.00019

Cited by 8 publications

(18 citation statements)

References 57 publications

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“…A later retrospective study demonstrated PE rates of 0.5% and 2.4% for isolated IJV thrombosis and combined subclavian/axillary vein and IJV thrombosis, respectively [6–8]. …”

Section: Discussionmentioning

confidence: 99%

“…Later on, the association of cancer and thrombophlebitis was observed by Armand Trousseau, who in 1861 stated that if the diagnosis of a suspected carcinoma of an internal organ could not be verified, the sudden and spontaneous appearance of thrombophlebitis in a large vein afforded necessary proof for diagnosis. He showed the relationship between gastric carcinoma and thrombosis [8–10]. …”

Section: Discussionmentioning

confidence: 99%

“…However, in the presence of septic emboli or with clear evidence of clot propagation, many physicians choose to add systemic anticoagulation, as in our patients [4, 8–10]. …”

Section: Discussionmentioning

confidence: 99%

“…Ultrasonographic findings include a dilated and incompressible vein, intraluminal clot (a late finding), and no response to the Valsalva maneuver (expected change in intraluminal volume secondary to enhanced venous return) [2, 4, 6, 8]. …”

Section: Introductionmentioning

confidence: 99%

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Bilateral internal jugular vein thrombosis due to malignant tumor

et al. 2018

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BackgroundThe aim of the study was to analyze characteristics of patients with bilateral internal jugular vein thrombosis in our department during a 1-year period.Internal jugular vein thrombosis refers to an intraluminal thrombus occurring anywhere from the intracranial internal jugular vein to the junction of the internal jugular vein and the subclavian vein, which form the brachiocephalic vein. It can occur spontaneously or as a complication of head and neck infections, surgery, central venous lines, local malignancy, polycytemia, hyperhomocysteinemia, neck massage, or intravenous drug abuse. Spontaneous bilateral internal jugular vein thrombosis may occur as a result of a neoplasm, a condition called Trousseau’s syndrome.MethodsThe medical records of four patients with internal jugular vein thrombosis were reviewed for patient clinical characteristics, including age, sex, and other diseases. This is a retrospective study, and we analyzed four patients who had distant malignant tumors.ResultsDuring a 1-year period, four male patients were referred to our department for bilateral internal jugular vein thrombosis. Three of them had lung neoplasm, and one had urinary tract neoplasm. Three patients had thrombosis in the upper arm at the same time, one of them in both arms. Therapy consisted of unfractioned heparin in all patients. The main clinical manifestations were pain and cervical edema. The time between the first clinical manifestation and diagnosis of internal jugular vein thrombosis was 4 days. In the current study, no patient exhibited complications due to internal jugular vein thrombosis.ConclusionsDiagnosing internal jugular vein thrombosis requires a high degree of suspicion. Our study underlines that bilateral internal jugular vein thrombosis is a risk indicator for malignancy. In our literature review of internal jugular vein thrombosis, 85% of patients exhibited unilateral thrombosis, whereas the remaining patients had bilateral thrombosis (15%). The knowledge of predictive factors of internal jugular vein thrombosis seems to be of utmost importance to improve patient management.

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“…A later retrospective study demonstrated PE rates of 0.5% and 2.4% for isolated IJV thrombosis and combined subclavian/axillary vein and IJV thrombosis, respectively [6–8]. …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…However, in the presence of septic emboli or with clear evidence of clot propagation, many physicians choose to add systemic anticoagulation, as in our patients [4, 8–10]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bilateral internal jugular vein thrombosis due to malignant tumor

et al. 2018

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“…A review done by Shakeel et al . illustrated many other causes including deep head and neck infections, intravenous drug abuse, hypercoagulable disorders, ovarian hyperstimulation, and malignancies [6]. …”

Section: Discussionmentioning

confidence: 99%

Internal jugular venous thrombosis due to Trousseau’s syndrome as the presenting feature of metastatic prostate carcinoma: a case report

et al. 2016

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BackgroundInternal jugular vein thrombosis is a rare vascular event with a potentially fatal outcome. Of the known etiologies, internal malignancies, either known or occult, are well described. Even though malignancies are known to present with internal jugular vein thrombosis, it rarely occurs due to prostate carcinoma. Many cases of jugular vein and superior vena cava thrombosis secondary to malignancies are due to metastatic compression of veins. Recurrent and unusual vascular thrombosis due to hypercoagulability associated with malignancies is also known as Trousseau’s syndrome. Here we report a rare case of a patient with internal jugular vein thrombosis as a presenting feature of metastatic prostate carcinoma, which is a case of Trousseau’s syndrome.Case presentationA 75-year-old Sri Lankan man with hypertension, hyperlipidemia, and past history of spontaneous intracranial hemorrhage presented with a short history of painless swelling in his left supraclavicular fossa. An examination revealed the swelling was due to a thickened left external jugular vein. A duplex ultrasound scan revealed left-sided internal jugular, external jugular, and brachiocephalic venous thrombosis. Surveillance into underlying malignancies showed an irregular, hard prostate gland suspicious of prostate carcinoma, which was proven with histology, and biochemically. A computed tomography scan found extensive vertebral, pelvic bone, intra-abdominal lymph node metastasis, and a single right-sided lower lung metastatic lesion, with no direct involvement of the jugular vein.ConclusionsSpontaneous thrombosis of the internal jugular vein due to Trousseau’s syndrome is rare and unusual. Clinicians should promptly investigate for malignancies as it can be the first presentation of underlying occult malignancies. Although prostate carcinomas are rare to present with internal jugular vein thrombosis, this case illustrates the importance of having a high degree of suspicion in the appropriate clinical setting.

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