Idiopathic External Jugular Vein Thrombosis

Area of Science:

• Vascular Surgery
• Emergency Medicine
• Diagnostic Imaging

Background:

• External jugular vein thrombosis is a rare condition, often secondary to trauma, infection, or malignancy.
• Spontaneous thrombosis of the external jugular vein is exceptionally uncommon.
• A sudden neck lump can be the sole presenting symptom.

Purpose of the Study:

• To report a rare case of spontaneous external jugular vein thrombosis.
• To highlight the diagnostic utility of point-of-care ultrasound in Emergency Departments.
• To emphasize the importance of considering jugular thrombosis in the differential diagnosis of neck masses.

Main Methods:

• Case report of a 69-year-old woman with a sudden onset neck lump.
• Physical examination and neck ultrasound to identify the thrombus.
• Comprehensive laboratory workup including coagulation profile, autoimmunity, and malignancy screening.
• Initiation of anticoagulation therapy.

Main Results:

• A 3 cm neck lump was found to be a non-occlusive thrombus in the right external jugular vein via ultrasound.
• Diagnostic workup revealed no identifiable triggering factors, classifying the thrombosis as idiopathic.
• Anticoagulation treatment resulted in complete resolution of the thrombus without recurrence.

Conclusions:

• Vascular conditions like jugular vein thrombosis should be considered in the differential diagnosis of painless, rapidly growing neck lumps.
• Idiopathic external jugular vein thrombosis necessitates thorough investigation to rule out underlying causes.
• Point-of-care ultrasound is a valuable tool for rapid and accurate diagnosis of venous thrombosis in emergency settings.