Sundaram Jegadeesh, Menon Prema, Thingnum Shyam K S, Rao Katragadda Lakshmi Narasimha
Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Pediatr Surg. 2016 Jul;51(7):1216-9. doi: 10.1016/j.jpedsurg.2016.04.019. Epub 2016 May 13.
Phlebectasia affecting the internal jugular vein is a rare cause of a benign neck swelling in children. They are mostly asymptomatic and therefore managed conservatively. Ligation of the vein and excision is usually avoided owing to the worry of raised intracranial pressure. We report a case of a large right internal jugular vein phlebectasia, causing dysphagia in a 7month old male child. Contrast enhanced computed tomography with 3-D reconstruction helped in pre-operative anatomical delineation, especially of the lower extent. It was excised through a cervico-thoracic approach with postoperative amelioration of symptoms. Contrary to expectation, the ectasia was not friable and was covered with a pseudocapsule of fibrofatty tissue, making excision easy.
影响颈内静脉的静脉扩张是儿童良性颈部肿胀的罕见原因。它们大多无症状，因此采取保守治疗。由于担心颅内压升高，通常避免结扎静脉和切除。我们报告一例7个月大男童因右侧颈内静脉巨大静脉扩张导致吞咽困难的病例。增强CT三维重建有助于术前进行解剖定位，尤其是对病变下部范围的定位。通过颈胸联合入路将其切除，术后症状改善。与预期相反，扩张的静脉并不脆弱，表面覆盖有纤维脂肪组织假包膜，便于切除。
