Jugular Vein Phlebectasia (IJP): Surgically Manageable But Ignored Entity
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CLINICAL REPORT
Jugular Vein Phlebectasia (IJP): Surgically Manageable But Ignored Entity Parvez Husain1,5
•
Shikhar Saxena2 • Shaheen Khalil Ahmed3 • Anita Tapparwal4
Received: 18 August 2020 / Accepted: 28 September 2020 Ó Association of Otolaryngologists of India 2020
Abstract IJP is a rare, congenital, benign, isolated, sporadically occurring fusiform or saccular dilatation of Internal Jugular Vein (IJV) of unknown aetiology usually presenting as a unilateral neck mass. It is mostly seen in children and young adults. We report a 4 year old male presented to Expert ENT & Diagnostic Centre presenting with history of painless right neck swelling in the right carotid triangle first observed on crying with no history of trauma, facial congestion, chronic cough, difficulty in swallowing or breathing, non febrile, venous humps, heaviness or cessation of normal voice. Diagnosis of right IJP was made. Exploration and wrapping the dilated segment in 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. Keywords Internal Jugular Vein Ignored Phlebectasia
& Parvez Husain [email protected] 1
Department of ENT, Expert ENT & Diagnostic Centre, Barabanki, India
2
Department of ENT, Saxena’s J P Hospital, Farrukhabad, India
3
Department of Anaesthesia, Expert ENT & Diagnostic Centre, Barabanki, India
4
Department Of ENT, ESIC Model Hospital, Gurgaon, Haryana, India
5
41, Indira Market, Barabanki, Uttar Pradesh 225001, India
Introduction IJP is a rare, congenital, benign, isolated, sporadically occurring fusiform or saccular dilatation of Internal Jugular Vein(IJV) of unknown aetiology usually presenting as a unilateral neck mass. It is mostly seen in children and young adults [1]. Phlebectatsia even though reported in all neck veins internal jugular, external jugular, anterior jugular and superficial communicants is seen in these in decreasing frequency [2] Although the exact aetiology of this entity is still unknown many hypothesis have been proposed in this regard [3]. Since this condition is comparatively rare a greater area of suspicion needs to be considered when dealing with this situation. The condition is often misinterpreted as Laryngocele, Pharyngeal Pouch, Cavernous Hemangioma, Cystic Hygroma, Brachial Cyst, Cyst of Upper Mediastinum & Inflation of Pulmonary Apical Bullae. Surgical treatment, usually with esthetic purposes, consists of the excision of the dilated portion of the vein or a unilateral excision of the vein. In this particular case exploration and wrapping of the dilated segment in a 8-mm-diameter polytetrafluoroethylene (PTFE) tube graft was done.
Materials and Methods We report a 4 year old male presented to Expert ENT & Diagnostic Centre presenting with history of painless right neck swelling in the right carotid triangle (Fig.
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