Ball Elizabeth, Morris-Stiff Gareth, Coxon Mari, Lewis Michael H
Department of Surgery, Royal Glamorgan Hospital, Ynysmaerdy, Llantrisant, Wales, UK.
J Med Case Rep. 2007 Dec 20;1:184. doi: 10.1186/1752-1947-1-184.
Internal jugular vein thrombosis (IJVT) is a rare but potentially fatal condition. It usually arises following trauma to the internal jugular vein but is also seen in association with coagulopathies and advanced malignancies as part of a para-neoplastic syndrome.
We report a case of a 44 year old woman with a strong past medical history and family history of thrombotic disease who presented with abdominal pain and ascites. A stage III ovarian carcinoma was diagnosed and she underwent debulking of the tumour. She sustained a peri-operative haemorrhage and required insertion of a central line into the right internal jugular vein. At one month follow-up she presented as an emergency with a left neck mass and painful swallowing. A duplex ultrasound of her neck identified a left IJVT to the level of the brachiocephalic vein which had occurred despite warfarinisation and an INR of greater than 2. She was commenced on intravenous heparin and the swelling resolved over the course of a week.
This case illustrates an unusual presentation of a rare condition. In this case, the precise aetiology is unclear as the IJVT may have been related to a coagulopathy or the presence of advanced malignancy and occurred despite adequate anticoagulation.
颈内静脉血栓形成（IJVT）是一种罕见但可能致命的疾病。它通常在颈内静脉受到创伤后发生，但也可见于作为副肿瘤综合征一部分的凝血病和晚期恶性肿瘤患者。
我们报告一例44岁女性患者，其有血栓形成疾病的既往病史和家族史，因腹痛和腹水就诊。诊断为III期卵巢癌，她接受了肿瘤减灭术。她在围手术期发生出血，需要在右颈内静脉插入中心静脉导管。在术后1个月随访时，她因左侧颈部肿块和吞咽疼痛作为急诊就诊。对其颈部进行的双功超声检查发现，尽管已服用华法林且国际标准化比值（INR）大于2，但仍发生了左侧颈内静脉血栓形成，血栓延伸至头臂静脉水平。她开始接受静脉肝素治疗，肿胀在一周内消退。
本病例说明了一种罕见疾病的不寻常表现。在本病例中，确切病因尚不清楚，因为颈内静脉血栓形成可能与凝血病或晚期恶性肿瘤的存在有关，且尽管进行了充分的抗凝治疗仍发生了血栓形成。
