alexa Internal Jugular Vein Aneurysm Presenting after Emesis Episode | OMICS International
ISSN: 2329-9495
Angiology: Open Access
Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Internal Jugular Vein Aneurysm Presenting after Emesis Episode

Adenauer Marinho de Oliveira Góes Junior*, Reinaldo Sergio Monteiro Franco and Simone de Campos Vieira Abib

Department of University Center of Pará State, Brazil

*Corresponding Author:
Adenauer Marinho de Oliveira Góes Junior
department of Vascular Surgery
University Center of Pará State, Brazil
Tel: +559181279656
Email: [email protected]

Received Date: May 03, 2014; Accepted Date: June 04, 2014; Published Date: June 15, 2014

Citation: de Oliveira Góes Junior AM, Monteiro Franco RS, de Campos Vieira Abib S (2014) Internal Jugular Vein Aneurysm Presenting after Emesis Episode. Angiol 2:130. doi:10.4172/2329-9495.1000130

Copyright: © 2014 de Oliveira Góes Junior AM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Angiology: Open Access


75% percent of all jugular vein aneurysms cases are diagnosed in children. The authors present an unusual case of a voluminous internal jugular vein aneurysm in a 40 year-old woman. The patient developed a progressive enlarging cervical bulging after an intense emesis episode five years before. The aneurysm was managed by cervicotomy and jugular vein ligature and the patient had an uneventful postoperative recovery. The authors provide a brief review of diagnosis aspects and treatment options for this disease.


Jugular vein aneurysm; Jugular vein phlebectasia; Venous aneurysm


Proper classification of venous malformations has not been established and the applied terms for venous dilatation lesions are variable [1]. Although some authors frequently use “phlebectasia” to describe fusiform dilatations and “aneurysm” for saccular ones, these terms are often used as synonyms [1].

Even though venous aneurysms occur equally between genders and are seen at any age, the vast majority of jugular vein aneurysms (JVAs) cases, about 75%, are diagnosed in children [1-3].

Case Report

A 40-year-old woman developed a right cervical mass after an intense emesis episode five years before presenting to our institution. The mass enlarged over the years and when the patient sought for treatment she described aesthetical complaints and a sensation like the bulge “was about to rupture” during situations associated with increased central venous pressure such as exercises and defecation. The patient denied previously pregnancies and comorbidities.

Physical examination demonstrated a large, soft, painless and delimited mass at the right cervical region. The bulge presented marked volume increase during Valsalva maneuver (which was easily observed since the patient was not obese) and nor thrill or murmur were detectable.

A computed tomography (CT) angiography revealed a right internal jugular vein aneurysm with a 4.3 cm diameter (Figures 1 and 2).


Figure 1: Angio TC image. The arrow points the right internal jugular vein aneurysm.


Figure 2: Angio TC image showing the right internal jugular vein aneurysm.

The progressive growth, presence of symptoms and aesthetic complains were all factors that indicate the need for intervention.

Surgical treatment was carried under general anesthesia; the procedure consisted of cervicotomy (10 cm length parallel to the sternocleidomastoid muscle) and jugular vein ligature proximally and distally to the aneurysm limits (Figure 3). It was necessary to dissect and ligate the internal jugular vein just behind the subclavian artery; this maneuver became easier when the operative table was put on proclive position as the diminished central venous pressure reduced the jugular diameter.


Figure 3: Intraoperative photo. The arrow points the right internal jugular vein aneurysm.

Surgery and postoperative recovery were uneventfully and the patient was discharged on the second postoperative day.

The patient remained on outpatient treatment for 6 months without new complaints and then was discharged.


JVAs most commonly present as soft, painless, compressible neck masses that enlarge during Valsalva maneuver [2,3,4,5]. Differential diagnosis includes cystic mediastinal masses, apical lung masses, laryngoceles,

Jbecause of JVAs rare incidence, treatment guidelines are not clearly established [1,3,4,].

As JVAs rarely present such complications, they should be operated only if symptomatic, enlarging, disfiguring or if either spontaneous or trauma related rupture is a concern [.

Several different surgical treatments have been described. Operative intervention may consist of tangential excision and lateral venorrhaphy or excision with or without interposition grafting but most commonly, simple vein ligation and resection have been performed for unilateral lesions, with an associated low incidence of complication [2-4]. The largest surgical experience documented a series of interventions on 46 patients with internal JVA, in which 32 patients underwent ligation. Three of these patients experienced subsequent symptomatic intracranial hypertension, with one instance of associated pontine infarct. All three cases resolved with medical therapy, and no other complications have been reported in the literature [3]. Although endovascular procedures have been described for venous dilatations and arterio-venous fistulas, because the patient presented low risk for an open surgery and the lesion was superficial an endovascular option was not considered [8].

In conclusion, JVAs are rare entities that should be correctly differentiated from other cervical bulges and, when indicated, surgical management should be performed to prevent complications such as venous thrombosis, pulmonary embolism and aneurysm rupture.


Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Recommended Conferences

  • 7th International Conference on Clinical and Medical Case Reports June 01-02, 2018 Osaka, Japan
    June 01-02, 2018 Osaka, Japan
  • ICACCM 2018 : 20th International Conference on Anesthesiology and Critical Care MedicineToronto, Canada June 21 - 22, 2018
    June 21-22, 2018 Dublin, Ireland
  • 7th International Conference and Exhibition on Surgery June 21-23, 2018 Dublin, Ireland
    June 21-23, 2018 Dublin, Ireland Dublin, Ireland

Article Usage

  • Total views: 12692
  • [From(publication date):
    October-2014 - May 27, 2018]
  • Breakdown by view type
  • HTML page views : 8866
  • PDF downloads : 3826

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2018-19
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals


[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

© 2008- 2018 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
Leave Your Message 24x7