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Lahiri R, Rawat SS, Russal Starlet A, Ahmed I. Right internal juglar vein phlebectasia: a diagnostic conundrum. BMJ Case Rep 2024; 17:e261625. [PMID: 39074942 DOI: 10.1136/bcr-2024-261625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
Phlebectasia of the internal jugular vein (IJV) is an unusual vascular anomaly, particularly in paediatric patients. Here, we present a case of IJV phlebectasia of a girl in her early childhood, highlighting its clinical presentation, diagnostic workup and management. The patient presented with a painless, non-pulsatile neck mass, which was identified as an enlarged IJV on imaging studies. Since it is a benign condition, and the patient is asymptomatic, observation with regular monitoring is advised.
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Affiliation(s)
- Raja Lahiri
- Cardio-Thoracic and Vascular Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shubham Singh Rawat
- Cardio-Thoracic and Vascular Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Abisho Russal Starlet
- Cardio-Thoracic and Vascular Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Intezar Ahmed
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Srinivasa V, Jayendiran S, Kayarkar D, Aliyar A, Aravind TI. Bilateral internal jugular vein ectasia: A rare cause of neck swelling. THE NATIONAL MEDICAL JOURNAL OF INDIA 2023; 36:23-25. [PMID: 37615138 DOI: 10.25259/nmji_282_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Internal jugular vein ectasia or phlebectasia is a condition in which there is an isolated fusiform dilatation of the internal jugular vein. The patient usually presents with swelling in the neck, which aggravates in size while coughing or straining. This is a rare condition and is often mis-diagnosed. It can be diagnosed by proper history, clinical examination and imaging. We report a 5-year-old boy who had bilateral internal jugular vein ectasia aggravating in size while straining and coughing. Ultrasonography and computed tomography scan showed dilatation of internal jugular veins on both sides. Since the patient was asymptomatic and had no complications, he was advised regular follow-up. This rare benign condition should be kept in mind as a differential diagnosis of an expansile neck mass.
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Affiliation(s)
- V Srinivasa
- Department of ENT, Vinayaka Mission's Medical College and Hospital, Pondicherry 609609, India
| | - S Jayendiran
- Department of ENT, Vinayaka Mission's Medical College and Hospital, Pondicherry 609609, India
| | - Darshan Kayarkar
- Department of ENT, Vinayaka Mission's Medical College and Hospital, Pondicherry 609609, India
| | - Aleena Aliyar
- Vinayaka Mission's Medical College and Hospital, Pondicherry 609609, India
| | - T I Aravind
- Department of ENT, Vinayaka Mission's Medical College and Hospital, Pondicherry 609609, India
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Tran VB, Pacquelet B, Dugué J. An unusual cervical swelling. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 139:301-303. [PMID: 34895849 DOI: 10.1016/j.anorl.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- V B Tran
- Service d'ORL-CCF, CHU de Caen Normandie, 14000 Caen, France.
| | - B Pacquelet
- Service de radiologie, CHU de Caen Normandie, 14000 Caen, France
| | - J Dugué
- Service d'ORL-CCF, CHU de Caen Normandie, 14000 Caen, France
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Stevens KE, Price JE, Marko J, Kaler SG. Neck masses due to internal jugular vein phlebectasia: Frequency in Menkes disease and literature review of 85 pediatric subjects. Am J Med Genet A 2020; 182:1364-1377. [PMID: 32293788 DOI: 10.1002/ajmg.a.61572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/31/2020] [Accepted: 02/24/2020] [Indexed: 11/06/2022]
Abstract
Classic Menkes disease is a rare X-linked recessive disorder of copper metabolism caused by pathogenic variants in the copper transporter gene, ATP7A. Untreated affected individuals suffer failure to thrive and neurodevelopmental delays that begin at 6-8 weeks of age and progress inexorably to death, often within 3 years. Subcutaneous injections of Copper Histidinate (US Food and Drug Administration IND #34,166, Orphan product designation #12-3663) are associated with improved survival and neurological outcomes, especially when commenced within a month of birth. We previously identified internal jugular vein phlebectasia (IJP) in four Menkes disease subjects. This feature and other connective tissue abnormalities appear to be consequences of deficient activity of lysyl oxidase, a copper-dependent enzyme. Here, we report results from a prospective study of IJP based on 178 neck ultrasounds in 66 Menkes subjects obtained between November 2007 and March 2018. Nine patients met the criterion for IJP (one or more cross-sectional area measurements exceeding 2.2 cm2 ) and five subjects had clinically apparent neck masses that enlarged over time. Our prospective results suggest that IJP occurs in approximately 14% (9/66) of Menkes disease patients and appears to be clinically benign with no specific medical or surgical actionability. We surveyed the medical literature for prior reports of IJP in pediatric subjects and identified 85 individuals and reviewed the distribution of this abnormality by gender, sidedness, and underlying etiology. Taken together, Menkes disease accounts for 16% (15/94) of all reported IJP individuals. Neck masses from IJP represent underappreciated abnormalities in Menkes disease.
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Affiliation(s)
- Kristen E Stevens
- Section on Translational Neuroscience, Molecular Medicine Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.,George Washington University School of Nursing, Washington, District of Columbia, USA
| | - Julienne E Price
- Section on Translational Neuroscience, Molecular Medicine Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Jamie Marko
- Department of Diagnostic Imaging, NIH Clinical Center, Bethesda, Maryland, USA
| | - Stephen G Kaler
- Section on Translational Neuroscience, Molecular Medicine Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA.,Center for Gene Therapy, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, Ohio, USA
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Pulsatile Tinnitus Caused by Internal Jugular Phlebectasia in an Adult. J Craniofac Surg 2020; 31:e161-e163. [PMID: 31934968 DOI: 10.1097/scs.0000000000006123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Internal jugular phlebectasia is a rare condition. Children with internal jugular phlebectasia are often discovered by their parents when they notice a soft mass in the neck that appears when the child cries, coughs, or breathes deeply. Most internal jugular vein dilatations occur unilaterally on the right side according to the literature reports. To our knowledge, no other internal jugular phlebectasia patients reported pulsatile tinnitus as the major complaint without a soft mass in the neck. The authors reported a female adult patient with left-side internal jugular phlebectasia with pulsatile tinnitus as the major complaint without a soft mass in the neck. Internal jugular phlebectasia was diagnosed by color ultrasound of the internal jugular vein. Pure-tone audiometry, tympanometry, hemoglobin, thyroid function, and magnetic resonance imaging were made to differentiate other diseases that can cause the pulsatile tinnitus. Conservative treatment is recommended in this report. The possibility of internal jugular vein dilatation should be considered when differentiate the possible diseases that caused pulsatile tinnitus.
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Mehta R, Kamble P, Nagarkar NM. Varied Presentation of Venous Ectasia Head and Neck: Case Series and Review of Literature. Indian J Otolaryngol Head Neck Surg 2019; 71:647-651. [PMID: 31742036 DOI: 10.1007/s12070-018-1457-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 07/17/2018] [Indexed: 11/29/2022] Open
Abstract
Jugular venous ectasia in head and neck region is a rare entity. They may present as asymptomatic neck masses and should be considered in the differential diagnosis of cystic neck masses. Management is individualised based on the patient and includes conservative or surgical management. We hereby report three cases of venous ectasia (2-external jugular and 1-facial vein) managed at our institute.
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Affiliation(s)
- Rupa Mehta
- Department of Otorhinolaryngology, Head and Neck Surgery, All India Institute of Medical Sciences, Raipur, Raipur, Chhattisgarh India
| | - Payal Kamble
- Department of Otorhinolaryngology, Head and Neck Surgery, All India Institute of Medical Sciences, Raipur, Raipur, Chhattisgarh India
| | - Nitin M Nagarkar
- Department of Otorhinolaryngology, Head and Neck Surgery, All India Institute of Medical Sciences, Raipur, Raipur, Chhattisgarh India
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Pasolini MP, Spinella G, Del Prete C, Valentini S, Coluccia P, Auletta L, Greco M, Meomartino L. Ultrasonographic assessment of normal jugular veins in Standardbred horses. BMC Vet Res 2019; 15:343. [PMID: 31619232 PMCID: PMC6794831 DOI: 10.1186/s12917-019-2104-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 09/20/2019] [Indexed: 11/21/2022] Open
Abstract
Background Ultrasonography (US) is the recommended imaging technique to evaluate jugular veins. This prospective randomized clinical study was designed to collect a series of B-mode US measurements of manually distended jugular veins in healthy Italian Standardbreds and to find possible correlations between ultrasound measurements and animal morphometric characteristics. Forty-two horses, eight males and 34 females (range 3–22 years; bodyweight 494.4 ± 41.7 kg), were included in the study. The diameters and wall thicknesses of both jugular veins were measured at three different sites of the neck. The differences in ultrasound measurements based on scans, age, gender, side, and site of the neck were evaluated by ANOVA or by the Kruskal-Wallis test. The effects of the morphometric measures on each ultrasound parameter were evaluated by MANOVA (P < 0.05). Results The ultrasound measurements did not differ significantly between the three different sites or between genders; hence, they were pooled together in the results. On the transverse scan, the mean dorsoventral and lateromedial diameters were 1.58 ± 0.23 and 2.20 ± 0.25 cm, respectively; the mean superficial and deep wall thicknesses (SWT and DWT) were 0.07 ± 0.01 and 0.08 ± 0.01 cm, respectively. On the longitudinal scan, the mean dorsoventral diameter was 1.59 ± 0.26 cm, and the SWT and DWT were both 0.08 ± 0.01 cm. Neck length, from the caudal edge of the mandible to the thoracic inlet, was related to the dorsoventral diameter in both longitudinal and transverse scan and to the SWT and DWT in transverse scan, whereas height at the withers (measured with tape) and estimated weight were related to the wall thickness. Dividing the subjects into groups by age in years (“young” 3–7, “mature” 8–14, “old” > 14), differences were found for the lateromedial diameter in the transverse scan and the SWT on the longitudinal scan. The main limitation of this study was that only one operator performed the measurements. Conclusion The US measurements of the jugular veins and their relationship with morphometric measures reported in this manuscript might be considered as guidelines both for early diagnosis and monitoring jugular vein abnormalities in healthy Italian Standardbred horses.
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Affiliation(s)
- Maria Pia Pasolini
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via a Federico Delpino, 1, 80137, Naples, Italy
| | - Giuseppe Spinella
- Department of Veterinary Medical Sciences, University Alma Mater of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, BO, Italy
| | - Chiara Del Prete
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via a Federico Delpino, 1, 80137, Naples, Italy.
| | - Simona Valentini
- Department of Veterinary Medical Sciences, University Alma Mater of Bologna, via Tolara di Sopra 50, 40064, Ozzano dell'Emilia, BO, Italy
| | - Pierpaolo Coluccia
- Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Via a Federico Delpino, 1, 80137, Naples, Italy
| | - Luigi Auletta
- IRCCS SDN, via E. Gianturco 113, 80143, Naples, Italy
| | - Michele Greco
- Clevedale Veterinary Practice, Home Farm, Redcar, UK
| | - Leonardo Meomartino
- Interdepartmental Radiology Centre, University of Naples Federico II, Via Federico Delpino 1, 80137, Naples, Italy
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Figueroa-Sanchez JA, Ferrigno AS, Benvenutti-Regato M, Caro-Osorio E, Martinez HR. Internal jugular phlebectasia: A systematic review. Surg Neurol Int 2019; 10:106. [PMID: 31528444 PMCID: PMC6744733 DOI: 10.25259/sni-217-2019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 05/01/2019] [Indexed: 01/21/2023] Open
Abstract
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.
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Affiliation(s)
- Jose A Figueroa-Sanchez
- Institute of Neurology and Neurosurgery, Hospital Zambrano Hellion, San Pedro Garza García, N.L., México
| | - Ana S Ferrigno
- Institute of Neurology and Neurosurgery, Hospital Zambrano Hellion, San Pedro Garza García, N.L., México
| | - Mario Benvenutti-Regato
- Institute of Neurology and Neurosurgery, Hospital Zambrano Hellion, San Pedro Garza García, N.L., México
| | - Enrique Caro-Osorio
- Institute of Neurology and Neurosurgery, Hospital Zambrano Hellion, San Pedro Garza García, N.L., México
| | - Hector R Martinez
- Institute of Neurology and Neurosurgery, Hospital Zambrano Hellion, San Pedro Garza García, N.L., México
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Internal jugular vein phlebectasia presenting with hoarseness of voice. Case Rep Vasc Med 2013; 2013:386961. [PMID: 24369523 PMCID: PMC3863558 DOI: 10.1155/2013/386961] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 09/24/2013] [Indexed: 11/28/2022] Open
Abstract
Internal jugular phlebectasia presents as a soft cystic mass in the neck that appears on straining. We present a case of a 7-year-old girl who presented with a painless soft cystic mass in the neck associated with hoarseness of voice. Based on clinical examination and CT image, diagnosis of right internal jugular phlebectasia was made.
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Nagata H, Uike K, Nakashima Y, Hirata Y, Yamamura K, Hara T. Diagnostic imaging of a child with congenital internal jugular vein phlebectasia. J Pediatr 2013; 163:1229-1229.e1. [PMID: 23751759 DOI: 10.1016/j.jpeds.2013.04.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 04/25/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Hazumu Nagata
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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11
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Abstract
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.
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Jianhong L, Xuewu J, Tingze H. Surgical treatment of jugular vein phlebectasia in children. Am J Surg 2006; 192:286-90. [PMID: 16920419 DOI: 10.1016/j.amjsurg.2006.02.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2005] [Revised: 02/13/2006] [Accepted: 02/13/2006] [Indexed: 02/05/2023]
Abstract
BACKGROUND Jugular vein phlebectasia (JVP) is a cervical mass that occurs relatively infrequently and usually presents in children as a soft cystic swelling in the neck during straining. It is liable to be misdiagnosed or managed inappropriately. This report elucidates the clinical presentation, diagnosis, treatment choices, and postoperative complications of JVP, and diagnostic methods and treatment choices are recommended. METHODS Fifty-one cases of JVP were reviewed (right vein in 38 patients, left in 7 patients, and bilateral in 6 patients). The internal jugular vein was involved the most frequently. The main complaint was a soft and compressible mass in the neck, becoming more prominent with the Valsalva maneuver. All of the children except 2 had an ultrasound or color Doppler flow imaging (CDFI) performed in combination with the Valsalva's breathing test. Surgical intervention was performed in 46 patients and the other 5 patients were followed-up conservatively for 2 to 15 years. RESULTS Ultrasound or CDFI showed local dilatation of unilateral or bilateral veins in all patients except 2, and confirmed the diagnosis in combination with the Valsalva's breathing test. Surgical intervention included ligation of the involved jugular vein in 32 patients, and longitudinal constriction suture venoplasty plus encapsulation with medical Dacron cloth or PTFE in 14 patients. All of the children who had surgery recovered uneventfully, except 3 patients undergoing ligation of the right internal jugular vein. CONCLUSIONS The Valsalva maneuver was most important for establishing the diagnosis. Ultrasound or CDFI, or in combination with the Valsalva's breathing test, was the diagnostic procedure of choice to confirm the diagnosis of JVP because of its clarity, safety, and low cost. Surgical intervention was recommended for cosmetic and psychologic purposes. Ligation or excision of the involved jugular vein was very safe, simple, and effective for most patients. However, in cases of lesions of the right and bilateral internal jugular veins, longitudinal constriction suture venoplasty plus encapsulation might be more preferable and safer, and should be recommended. Otherwise, treatment should be conservative (follow-up evaluation).
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Affiliation(s)
- Li Jianhong
- Department of Pediatric Surgery, Second University Hospital of Shantou University Medical College, Dongxia Bei Rd., Shantou City, Guangdong Province, People's Republic of China, 515041.
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Abstract
BACKGROUND/PURPOSE The purpose of the present study was to elucidate the clinical presentation, diagnosis, treatment, and postoperative complications of jugular vein phlebectasia (JVP), and to recommend diagnostic methods and treatment choices. MATERIALS AND METHODS Thirty-six cases of JVP were reviewed (right vein in 27, left in 6, and bilateral in 3). The internal jugular veins were the most commonly involved. The main complaint was the soft and compressible mass in the neck. Ultrasound or color Doppler flow imaging (CDFI) was performed on all the children. Surgical intervention was performed in 32 cases, and the other 4 cases were conservatively followed up for 4 to 6 years. RESULTS Ultrasound or CDFI demonstrated local dilatation of the unilateral or bilateral veins in all the patients. Surgical intervention included ligation of the involved jugular vein in 31 cases and draping with medical Dacron cloth in 1 case. All of the operated children recovered uneventfully, except 3 for cases who underwent ligation of the right internal jugular vein. CONCLUSIONS Valsalva maneuver was most important for establishing the diagnosis. Ultrasound or CDFI was the diagnostic procedure of choice to confirm the diagnosis of JVP. Surgical ligation or excision of unilateral jugular vein was recommended for cosmetic and psychological purposes. However, special attention must be paid to prevent postoperative complications in case of ligation of right internal jugular vein. Or else, treatment should be conservative (follow-up).
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Affiliation(s)
- Xianliang Hu
- Department of Pediatric Surgery, Medical College of Shantou University, Shantou City, Guangdong Province, China
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Abstract
Jugular phlebectasia is an entity that is being increasingly recognised in recent years. The term phlebectasia indicates dilatation of the vein without tortuosity. It has been described in almost all cervical veins. Internal jugular phlebectasia is seen more often on the right side. This paper reports two new cases, reviews all cases of internal jugular phlebectasia in children published in English literature upto 1996 and recommends diagnostic methods and treatment policy. This article also discusses a theory of pathogenesis for this condition based on the regional anatomical features, principles of vascular physics and pathologic findings.
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Affiliation(s)
- V Paleri
- Department of Ear, Nose and Throat Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
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Abstract
Phlebectasia is an abnormal dilatation of an isolated vein, may affect any vein, and is usually asymptomatic. When the internal jugular vein is involved, it presents as a cervical swelling that can mimic the signs of either pharyngocele or a laryngocele and, because of its rarity, is frequently misdiagnosed. We describe 2 cases of phlebectasia of internal jugular vein in children with voice change in one of them. No treatment is necessary for this benign, self-limiting condition. Clinical features, diagnosis, treatment options, and a review of the literature about this rare venous lesion are presented.
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Affiliation(s)
- J F Lubianca-Neto
- Department of Otorhinolaryngology of Fundação Faculdade Federal Ciências Médicas of Porto Alegre, Complexo Hospitalar Santa Casa, RS, Brazil
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Abstract
BACKGROUND Anterior neck mass which appears on straining should be differentiated from laryngocele, jugular venous system phlebectasia and superior mediastinal cysts or masses. Internal jugular phlebectasia is a fusiform dilatation of the internal jugular vein. PURPOSE this is an attempt to elucidate the etiology, clinical features, diagnosis, treatment and review of the literature about this rare venous lesion. METHODS an 11 year old boy presented with soft neck swelling on the right side which appeared on straining. The diagnosis was confirmed on the bases of ultrasonography combined with Doppler flow imaging and spiral computerized tomography scan with contrast. The patient was treated conservatively and followed up for 21 months without any changes. CONCLUSION internal jugular phlebectasia is a rare disease, which mostly involves the right side. It is usually a childhood disease and believed to be of congenital origin. It can occur at any age and affects both genders. Nevertheless no single case was reported in a young adult male. The diagnosis was made on a clinical basis and confirmed by less invasive radiologic technique. The investigations of choice are Doppler ultrasonography and spiral computerized tomography scan with contrast. Even though most of these lesions have been excised surgically, the treatment of choice should be conservative as long as it is asymptomatic.
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Affiliation(s)
- S al-Dousary
- Otolaryngology Department, King Abdulaziz University Hospital, Riyadh, Saudi Arabia
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