BackgroundThe 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.MethodsThe 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.ResultsDuring 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.ConclusionsDiagnosing 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.

Wandering spleen is a very rare defect characterized by the absence or weakness of one or more of the ligaments that hold the spleen in its normal position in the upper left abdomen. Patient symptomatology is variable and ranges from mere feeling of an abdominal lump to sudden abdominal pain due to infarction. Patients may have subacute to chronic abdominal or gastrointestinal complaints. Because of nonspecific symptoms, clinical diagnosis can be difficult; hence, imaging plays an important role. A major complication is splenic torsion, which is the cause of acute abdomen. We present a case of acute abdominal pain due to torsion of wandering spleen in a patient with Marfan Syndrome, valvular heart disease, and vertebral anomalies. Preoperative diagnosis was made on the basis of ultrasonography and computed tomography, which was later confirmed on surgery, and treated successfully.

Left ventricular (LV) thrombus is one of myocardial infarction (MI) complications and if the thrombus is mobile and protruding, there is a high risk of embolization. It is exceptionally rare that the presenting serious symptom of acute MI is severe leg pain. We report here a rare case of a 36-year-old Caucasian male patient with unrecognized MI complicated by LV thrombus. His initial visit to the physician was due to sudden onset of severe left leg pain as a consequence of thromboembolism. Medical examination revealed occluded left femoral commune artery and femoral superficial artery, subacute MI and apical LV thrombus, which were treated accordingly. On follow-up, 2 months after hospital discharge, patient affirmed that he has been walking for approximately 3 km every day, without leg cramps or angina. Early recognition of MI, even when presented with atypical symptoms in young individuals and its prompt treatment is important to improve survival, as well as to reduce thrombotic events.