Lønnebakken Mai Tone, Pedersen Ole Martin, Andersen Knut Sverre, Varhaug Jan Erik
Department of Heart Disease, Haukeland University Hospital, 5021 Bergen, Norway.
Case Rep Med. 2010;2010. doi: 10.1155/2010/645193. Epub 2010 Aug 11.
Internal jugular vein thrombosis is a serious event with potentially fatal outcome, where the clinical symptoms may be vague or absent. This paper refers to a rare case where routine carotid Doppler ultrasound prior to coronary artery bypass grafting (CABG) and aortic valve replacement (AVR) in a 76-year-old man, incidentally revealed thrombosis of the right internal jugular vein. Thoracic CT demonstrated an underlying, large, benign substernal multinodular goiter, mainly involving the right lobe, causing compression and displacement of the great vessels. A successful, one-stage operation including ligation of the internal jugular vein to avoid pulmonary embolism and hemithyroidectomy, combined with the scheduled CABG and AVR, was performed. This case illustrates that benign substernal goiter may be associated with asymptomatic internal jugular vein thrombosis. Carotid Doppler ultrasound should involve evaluation of the internal jugular vein concerning thrombosis as its presence may reveal space-occupying lesions in the thorax.
颈内静脉血栓形成是一种严重事件，可能导致致命后果，其临床症状可能不明确或不存在。本文报道了一例罕见病例，一名76岁男性在冠状动脉旁路移植术（CABG）和主动脉瓣置换术（AVR）前进行常规颈动脉多普勒超声检查时，意外发现右颈内静脉血栓形成。胸部CT显示一个位于胸骨后、巨大的良性多结节甲状腺肿，主要累及右叶，导致大血管受压和移位。进行了一次成功的一期手术，包括结扎颈内静脉以避免肺栓塞和甲状腺次全切除术，并联合预定的CABG和AVR。该病例表明，胸骨后良性甲状腺肿可能与无症状颈内静脉血栓形成有关。颈动脉多普勒超声检查应包括对颈内静脉血栓形成的评估，因为其存在可能揭示胸部占位性病变。
