Thrombosis of the internal jugular (IJ) is an often under-diagnosed condition that can occur as a result of complications of head and neck infections, or sometimes related to surgeries, central venous access, local malignancies, or intravenous drug abuse.
Sometimes, however, it can even occur spontaneously.
It is important to identify the problem early because IJ thrombosis can have very serious and potentially life threatening complications including systemic sepsis, chylothorax, papilledema, airway edema, and pulmonary embolism.
It is essential to see a doctor because the diagnosis is very hard to pin down and it requires a very serious and high degree and level of expert clinical suspicion.
The thrombosis can also become infected secondarily and result in septic thrombophlebitis.
Studies that have been done regarding the conditions suggest that the rate of the thrombosis can be lower for silastic hemodialysis catheters that are percutaneously inserted, in comparison to those that are implanted through surgery.
Sometimes the infection occurs as a result of Lemierre syndrome. Thankfully, since the introduction of antibiotics in the late 1950s, occurrences of Lemierre syndrome have fallen quite drastically.
There are no figures that give detailed statistics on the frequency of IJ thrombosis in people who are intravenous drug users, but it does occur quite commonly for people who have been injecting drugs into their veins for many years and have exhausted many of the veins commonly used.
Once the condition is diagnosed, the use of an anticoagulant therapy is what is commonly recommended.
However, there are no studies that are reliable enough regarding this treatment. But, the fact that the condition is severely under-diagnosed also points to the fact that many patients will do well without serious effects.
There is a risk of pulmonary embolisms, but this too isunder-researched.
In most cases of IJ thrombosis, a prolonged antibiotic therapy is commonly recommended to work against the anaerobic organisms as soon as the blood cultures are obtained. The duration of the antibiotic treatment is usually in between four and six weeks.
In some cases surgery is needed, but seldom in uncomplicatedones.
However, when there are deep neck infections that require drainage of fluid collections and a debridement of the infected tissue, then a surgery will be mandatory.
A case of intraluminal abscesses could also require the IJ vein to be excised so that the doctors can prevent greater and more serious damage to the area.
Usually surgery is not needed because there are very few cases of IJ thrombosis that cannot be treated with the right antibiotic therapy. In many cases, fevers will occur, especially in cases of metastatic infection.