Thrombosis of the internal jugular (IJ) is an oftenunder-diagnosed condition that can occur as a result of complications of headand 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 IJthrombosis can have very serious and potentially life threatening complicationsincluding systemic sepsis, chylothorax, papilledema, airway edema, andpulmonary embolism.
It is essential to see a doctor because the diagnosis isvery hard to pin down and it requires a very serious and high degree and levelof expert clinical suspicion.
The thrombosis can also become infected secondarily andresult in septic thrombophlebitis.
Studies that have been done regarding the conditionssuggest that the rate of the thrombosis can be lower for silastic hemodialysiscatheters that are percutaneously inserted, in comparison to those that areimplanted through surgery.
Sometimes the infection occurs as a result of Lemierresyndrome. Thankfully, since the introduction of antibiotics in the late 1950s, occurrencesof Lemierre syndrome have fallen quite drastically.
There are no figures that give detailed statistics on thefrequency of IJ thrombosis in people who are intravenous drug users, but itdoes occur quite commonly for people who have been injecting drugs into theirveins for many years and have exhausted many of the veins commonly used.
Once the condition is diagnosed, the use of an anticoagulanttherapy is what is commonly recommended.
However, there are no studies that are reliable enoughregarding this treatment. But, the fact that the condition is severelyunder-diagnosed also points to the fact that many patients will do well withoutserious effects.
There is a risk of pulmonary embolisms, but this too isunder-researched.
In most cases of IJ thrombosis, a prolonged antibiotictherapy is commonly recommended to work against the anaerobic organisms assoon as the blood cultures are obtained. The duration of the antibiotic treatmentis 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 requiredrainage of fluid collections and a debridement of the infected tissue, then asurgery will be mandatory.
A case of intraluminal abscesses could also require the IJvein to be excised so that the doctors can prevent greater and more seriousdamage to the area.
Usually surgery is not needed because there are very fewcases of IJ thrombosis that cannot be treated with the right antibiotictherapy. In many cases, fevers will occur, especially in cases of metastaticinfection.