|Year : 2021 | Volume
| Issue : 1 | Page : 59-60
Spontaneous external jugular vein pseudo-aneurysm
Sonal Saran, Khanak Kumar Nandolia
Department of Radiology, AIIMS, Rishikesh, Uttarakhand, India
|Date of Submission||13-Jun-2020|
|Date of Decision||22-Aug-2020|
|Date of Acceptance||18-Nov-2020|
|Date of Web Publication||25-Apr-2021|
Dr. Sonal Saran
Department of Radiology, AIIMS, Rishikesh, Uttarakhand
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Saran S, Nandolia KK. Spontaneous external jugular vein pseudo-aneurysm. J Med Evid 2021;2:59-60
A 65-year-old female presented to the surgical outpatient clinic with complaints of swelling over the right side of the neck for 3 months [Figure 1]. On examination, the swelling measured approximately 3 cm × 3 cm. It was present over the posterior triangle of the right side of the neck, supraclavicular in position. The swelling was soft and compressible on palpation, and the skin overlying the swelling was not warm and red. There were no visible or palpable pulsations present over the swelling; however, the swelling increased in size on coughing, sneezing or performing Valsalva. The patient was subjected to high-frequency ultrasound examination with a Doppler to look for the vascular origin of the lesion. On ultrasound examination, a well-defined cystic lesion measuring 2 cm × 2 cm × 2.5 cm was seen in the right supraclavicular region, which showed a stalk-like communication with the right external jugular vein (EJV) [Figure 2]a. On Doppler application, the venous waveform was seen. A provisional diagnosis of pseudo-aneurysm arising from the EJV was made. A contrast-enhanced computed tomography of the neck was performed, which further confirmed the diagnosis [Figure 2]b and [Figure 2]c.
|Figure 1: Swelling present over the posterior triangle of the right side of the neck in the supra-clavicular region|
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One of the most commonly encountered venous malformations of the neck includes jugular vein dilation or phlebectasia. The internal jugular vein is most commonly involved, followed by an EJV. Phlebectasia of the jugular vein is considered to be congenital in origin. Aneurysm of the jugular vein, on the other hand, can be spontaneous or related to aetiologies such as trauma, inflammation or tumour. These lesions are mostly left sided due to compression of the left innominate vein by a high atherosclerotic aorta in elderly hypertensive patients. Pseudo-aneurysm affecting the EJV is quite rare. The presence of a unilateral, soft, non-tender swelling in the neck which increases in size on Valsalva is characteristic of phlebectasia or venous aneurysm. An asymptomatic aneurysm can be managed conservatively with reassurance and follow-up. Surgical excision is offered if the aneurysm is painful or unacceptable cosmetically.
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The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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|Figure 2: (a) Doppler ultrasound examination showing a cystic lesion (star) in the right supra-clavicular region having a stalk-like communication with the right external jugular vein which fills up with colour. The common carotid artery is separately seen. (b and c) Contrast-enhanced computed tomography neck showing a contrast-filled pseudo-aneurysmal cavity (star) connected with the external jugular vein. The common carotid artery and the internal jugular vein are separately seen|
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| References|| |
Mohanty D, Jain BK, Garg PK, Tandon A. External jugular venous aneurysm: A clinical curiosity. J Nat Sci Biol Med 2013;4:2235.
[Figure 1], [Figure 2]