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Internal Jugular Vein Avulsion Controlled With Intraoperative Foley Balloon Occlusion Following Blunt Neck Trauma
Patrick D Melmer1, Alexander Simmonds2, Michel Aboutanos3
1Acute Care Surgery, Virginia Commonwealth University, Richmond, USA.
Cureus
|November 6, 2024
Summary
Blunt trauma rarely causes internal jugular vein injuries. A Foley balloon effectively controlled bleeding in a challenging neck zone II injury, aiding surgical repair and preventing hypoglossal nerve damage.
Area of Science:
- Trauma surgery
- Vascular surgery
- Emergency medicine
Background:
- Internal jugular vein (IJV) injuries from blunt trauma are exceptionally rare.
- Managing IJV injuries in high neck zones presents significant surgical challenges due to proximity to vital structures.
Observation:
- A case of severe IJV injury in neck zone II, adjacent to the hypoglossal nerve, is presented.
- The distorted and blood-stained surgical field complicated the management.
Findings:
- A Foley balloon was inserted into the cranial end of the IJV for hemorrhage control.
- This technique allowed for suture ligation of the injured vein.
- Balloon tamponade provided critical time for careful dissection, preserving the hypoglossal nerve.
Implications:
- Foley balloon tamponade is a viable strategy for managing challenging IJV injuries.
- This method facilitates surgical repair in complex anatomical situations.
- Preservation of the hypoglossal nerve is crucial to avoid neurological sequelae.
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