Figure 1 - available via license: Creative Commons Attribution-NonCommercial 4.0 International
Content may be subject to copyright.
Axial CT view. Image shows a large diameter of right internal jugular vein and air bubbles inside the vessel.
Source publication
Septic thrombosis of the internal jugular vein is a possible complication related to central venous catheters. The enlargement of the diameter of the jugular vein can stimulate phrenic nerve causing hiccups and, septic thrombus can metastasize to different organs threating patient's life. Diagnosis of septic thrombosis of internal jugular vein shou...
Context in source publication
Context 1
... this patient, hiccup etiology was difficult to identify and resulted in a diagnostic challenge, because fever and cervical inflammatory signs appeared days after hiccups. When signs and symptoms came together, a cervical TC was performed, concluding that manipulation of CVC led to a septic thrombosis of internal jugular vein, its dilatation and, finally, the direct compressive stimulation of phrenic and vagus nerves ( Figs. 1 and 2). Topaz et al described a case of uncontrollable hiccups after the insertion of a catheter into jugular internal vein because of the compression of phrenic nerve due to a hematoma [2,3]. ...
Citations
... The mechanism of venous thrombosis is attributed to Virchow's triad: endothelial damage, hypercoagulability, and alteration of blood flow [14]. In our case we have endothelial damage from an infected sewing needle and altered blood flow resulting from deep neck infection activate clotting factors initiating the thrombotic process. ...
... For patients with jugular vein thrombosis, most authors recommend conservative treatment with intravenous antibiotics and surgical drainage of deep neck infections. Internal jugular vein excision or anticoagulation therapy has not been recommended routinely [14]. ...
Introduction
The internal jugular vein thrombosis is usually due to intravenous drug abuse, prolonged central venous catheterization or deep head-neck infections or trauma. Related malignancies, or inflammatory etiologies are described. Our case is interesting by the ingestion of a sewing needle that passes from the pharynx to the internal jugular vein via migration, leading to life-threatening complications: deep neck space infection and internal jugular vein thrombosis.
Case report
We report a case of a 40 years old patient, for acute cervical cellulitis in a context of odynophagia and fever, a CT scan revealed a jugular vein thrombosis, penetrated by a metal density foreign body. The diagnosis of ingested foreign body complicated by cervical cellulitis and thrombosis of the internal jugular vein was made. The patient underwent neck surgery with intravenous antibiotics. The postoperative course was uneventful, after one year of follow-up, no complications have been observed.
Discussion
no consensus has been reached concerning the management of postoperative and post traumatic vein thrombosis. Taking into account the risk of extension of the thrombus and the hemorrhagic risk each case should involve discussions among a multidisciplinary team.
Conclusion
The internal jugular vein thrombosis is a rare complication of ingested foreign bodies which may lead to life threat. The early diagnosis and adequate treatment of its life-threatening complications may result in excellent prognosis.
