Internal Jugular Vein Duplication: Review and Classification

Abstract

Internal jugular vein duplication (IJVD) is a rare phenomenon. Twenty-one such instances in 18 individuals have been reported to date. We report an intra-operative case of unilateral IJVD in a 32-year-old male, who was operated for cancer of gingivobuccal sulcus. We have reviewed the published literature and have proposed a classification scheme in order to make future reporting systematic. The condition has been classified into type A, B and C based on their morphology. About 75 % of the reported cases are of Type A. Type C is the most complex of all the duplications. Though IJVD is physiologically inconsequential, it has clinical implications. Percutaneous catheterisation of the vein could be hazardous in all cases, but more so in type B and C duplications. As with any anomaly, the risk of accidental injury increases during surgical procedures. It is important to document findings of this anomaly in order to understand its anatomy and implications in a better way.

Concomitant Occurrence of Fenestrated Internal Jugular Vein and Sub-omohyoid External Jugular Vein: A Case Report

“…In type B, the duplication extends inferior to omohyoid tendon whereas in type C, duplication occurs around the level of hyoid bone and the lateral component of IJV might traverse outside the carotid sheath, in the posterior triangle and enter the carotid sheath at the root of the neck. [4] In accordance with the classification by Nayak et al, the present case falls under type A pattern.…”

“…Nayak et al proposed three morphological patterns of duplicated IJV. [4] In type A, duplication of IJV starts above the inferior border of posterior belly of digastric and united cranial to or at the level of central tendon of omohyoid muscle. The accessory nerve usually passes between the two IJVs.…”

“…[3] Another classification describes multiple IJVs as duplication and takes into account the level of duplication of IJV in relation to digastric muscle and hyoid bone. [4] Incidence of fenestrated IJV varies from 0.4 % to 1 % and is linked with phlebectasia or added vascular anomalies. [5,6]…”

Internal jugular vein agenesis: a rare vascular abnormality and incidental finding. A case of internal jugular vein agenesis in a 52-years old male

“…The incidence of developmental vascular anomalies in general population are seen in about 0.05%-0.25%, however agenesis of the IJV is rarely encountered and confirmed [2]. Different IJV abnormalities have been reported in scientific literature: partial or complete duplication [8], [9], [10], [11], [12], stenosis, complete occlusion, distortions, and intraluminal structures, such as membranes, webs, and inverted valves [13], [14], congenital external carotid artery-IJV fistula [15], congenital aneurysm [16], and fenestration [17].…”

Central venous catheterization in a patient with double right internal jugular vein and persistent left-sided superior vena cava draining into the left atrium

“…They may be identified during surgical neck dissection, radiologically and during cadaveric dissections. [ 1 ] The presence of two venous structures on neck ultrasound during IJV catheter placement can cause confusion and difficulty in puncture site selection. If the two limbs of a duplicated IJV join the subclavian vein separately at a right angles, it can cause difficulty or failure in the guidewire advancement.…”