IJV Phlebectasia: an approach algorithm

Abstract

Internal jugular venous (IJV) Phlebectasia are rare disorders. It is generally diagnosed at an early age, usually unidentified or misdiagnosed or ignored because of the scarcity of the knowledge on the disorder. We encountered a case of 7-year-old child with a right sided intermittent neck swelling which mimicked as an external laryngocele. But, the diagnosis of IJV Phlebectasia was made on “dynamic” ultrasound (USG) doppler study. Cervical adenopathy, mediastinal masses, tuberculosis and certain syndromes of connective tissue disorders were ruled out. The child was managed conservatively with parents and the child being educated about disorder.

Neck Swelling in A Child: Now You See it, Now You Don’t?

“…USG with Doppler flow is proven to be a gold standard to diagnose jugular ectasia. 3 USG is a short procedure and non-invasive technique. USG is capable to differentiate between a cystic and solid mass while Doppler flow imaging able to recognize the blood flow direction and any thrombosis within the vessel.…”

“…Serial follows up and biannually Doppler USG monitoring is recommended to look for progression, size and thrombosis risk. 3,4 Cosmetic reasons and complications of IJV ectasia may require ligation of the feeding vessels followed by surgical resection of the dilated segment. 10…”

“…USG combined with Doppler flow imaging is a gold standard to diagnose jugular ectasia. 3 Due to its benign nature, many considered conservative follow up is recommended for this condition, although surgical resection has been reported for the symptomatic patient.…”