Internal jugular vein thrombosis- prevalence, reasons and therapy.A restrospective analysis

Introduction:

Only < 5% of all deep vein thrombosis are located in the internal jugular vein. Reasons for thrombosis can be genetic, paraneoplastic or pregnancy-associated coagulation disorders, local infections culminating in Lemierre's syndrome, intravenous drug abuse, cervical trauma or intravenous catheters. Systematic reviews of internal jugular vein thrombosis are missing due to its small numbers.

Methods:

Our electronic patient records from 2012 – 2017 were searched for the diagnosis ‚thrombosis' and ‚internal jugular vein'. In total 40 patients with internal jugular vein thrombosis could be identified and analysed.

Results:

22/40 thromboses were of paraneoplastic origin. 15/22 suffered from an ENT cancer and 6 of those 22 were in a palliative or recurrent situation. In 4/22 patients thrombosis was already existent during initial diagnosis, in 18/22 it developed during the course of the disease. The majority of non-ENT-tumors were of lymphoproliferative origin. Internal jugular vein thrombosis was the first symptom of the disease in 2/7 non-ENT-tumors. Mainly streptococci-associated infections like cervical abscess could be seen in 15/40 patients. In one patient a central venous catheter was the origin, in two patients the reason for thrombosis remained unknown. Therapy of choice was anticoagulation in nearly all patients.

Conclusions:

Internal jugular vein thromboses are rare and often stay asymptomatic. To detect them, ultrasound should always include duplex- and doppler-sonography. The most likely reasons for thrombosis are paraneoplastic or infectious. They can be the first symptom of cancer and thus always need further clarification. Anticoagulation is normally indicated for 3 – 6 months.

Publication History

Publication Date:
18 April 2018 (online)