Leci-Tahiri Laura, Zherka-Saracini Harieta, Tahiri Afrim, Koshi Adhurim
Clinic of Vascular Surgery, University Clinical Center of Kosovo, 10000, Pristina, Kosovo.
Clinic of General Surgery, University Clinical Center of Kosovo, 10000, Pristina, Kosovo.
J Med Case Rep. 2018 Feb 20;12(1):42. doi: 10.1186/s13256-017-1556-0.
The aim of the study was to analyze characteristics of patients with bilateral internal jugular vein thrombosis in our department during a 1-year period. Internal jugular vein thrombosis refers to an intraluminal thrombus occurring anywhere from the intracranial internal jugular vein to the junction of the internal jugular vein and the subclavian vein, which form the brachiocephalic vein. It can occur spontaneously or as a complication of head and neck infections, surgery, central venous lines, local malignancy, polycytemia, hyperhomocysteinemia, neck massage, or intravenous drug abuse. Spontaneous bilateral internal jugular vein thrombosis may occur as a result of a neoplasm, a condition called Trousseau's syndrome.
The medical records of four patients with internal jugular vein thrombosis were reviewed for patient clinical characteristics, including age, sex, and other diseases. This is a retrospective study, and we analyzed four patients who had distant malignant tumors.
During a 1-year period, four male patients were referred to our department for bilateral internal jugular vein thrombosis. Three of them had lung neoplasm, and one had urinary tract neoplasm. Three patients had thrombosis in the upper arm at the same time, one of them in both arms. Therapy consisted of unfractioned heparin in all patients. The main clinical manifestations were pain and cervical edema. The time between the first clinical manifestation and diagnosis of internal jugular vein thrombosis was 4 days. In the current study, no patient exhibited complications due to internal jugular vein thrombosis.
Diagnosing internal jugular vein thrombosis requires a high degree of suspicion. Our study underlines that bilateral internal jugular vein thrombosis is a risk indicator for malignancy. In our literature review of internal jugular vein thrombosis, 85% of patients exhibited unilateral thrombosis, whereas the remaining patients had bilateral thrombosis (15%). The knowledge of predictive factors of internal jugular vein thrombosis seems to be of utmost importance to improve patient management.
本研究旨在分析我科1年内双侧颈内静脉血栓形成患者的特征。颈内静脉血栓形成是指从颅内颈内静脉至颈内静脉与锁骨下静脉汇合形成头臂静脉的任何部位管腔内出现血栓。它可自发发生，也可作为头颈部感染、手术、中心静脉置管、局部恶性肿瘤、红细胞增多症、高同型半胱氨酸血症、颈部按摩或静脉药物滥用的并发症出现。自发性双侧颈内静脉血栓形成可能是由于肿瘤，即所谓的特鲁索综合征所致。
回顾了4例颈内静脉血栓形成患者的病历，以了解患者的临床特征，包括年龄、性别和其他疾病。这是一项回顾性研究，我们分析了4例患有远处恶性肿瘤的患者。
在1年期间，4例男性患者因双侧颈内静脉血栓形成转诊至我科。其中3例患有肺癌，1例患有泌尿系统肿瘤。3例患者同时在上肢出现血栓，其中1例双侧上肢均有血栓。所有患者均采用普通肝素治疗。主要临床表现为疼痛和颈部水肿。从首次出现临床表现到诊断颈内静脉血栓形成的时间为4天。在本研究中，没有患者因颈内静脉血栓形成出现并发症。
诊断颈内静脉血栓形成需要高度怀疑。我们的研究强调双侧颈内静脉血栓形成是恶性肿瘤的一个风险指标。在我们对颈内静脉血栓形成的文献回顾中，85%的患者表现为单侧血栓形成，其余患者为双侧血栓形成（15%）。了解颈内静脉血栓形成的预测因素似乎对于改善患者管理至关重要。
