Bilateral

Internal Jugular Phlebectasia

In An Adult

Introduction
Laryngoceles
Pharyngoceles

Jugular Phlebectasia

congenital venous cyst

Harris (1928)
phlebectasia
Gerwig (1952)
bilateral phlebectasia in a child
Walsh (1992)
Twins with unilateral phlebectasia
Del Rosario,Phil. (1997)

Objective
To report a case of bilateral internal
jugular phlebectasia in an adult
and promote awareness of the disease.

CASE REPORT
General Data:
P.E. , 22 year old male, Marikina

Chief Complaint:
bilateral neck masses
that appear on straining

History of Present Illness:

(+) neck mass, L
on swallowing
(+) enlargement

7 months PTC

(+) neck mass, R

on straining

4 months PTC

OPD
consult

Review of Systems, Past Medical,

Family History, Personal/Social History
UNREMARKABLE

P. E.:
Neck Examination

Rest

Valsalva

Laryngoscopy
no masses
no bulging false cords
good vocal cord mobility

Ancillary Procedures:
1.

Pharyngo-esophagogram

2.

Ultrasound

3.

CT SCAN
Level C6

Rest
145%

110%
Valsalva

Level C4
Rest

15%

16%
Valsalva

Diagnosis:

Bilateral Internal Jugular Phlebectasia

DISCUSSION
Neck masses on straining:
Laryngocele/Pharyngoceles
Superior mediastinal tumors/cysts
Jugular phlebectasia

Laryngoceles
Hoarseness,Stridor,Dysphagia
Sore throat,Snoring,Cough
FVC swelling
Level of the thyrohyoid membrane
Air-filled sac on CT scan

Pharyngoceles & Mediastinal masses

Bombay Hospital Journal Online

Sanders, 1999
96% of pediatricians
40% of pediatric surgeons
37% of OTOLARYNGOLOGISTS

NOT AWARE!

Jugular Phlebectasia
A rare disease
Mostly in children
Frequently unilateral

Al-Dousary Int J Pediatr

Otorhinolaryngol 1997 Jan

Clinico-radiologic diagnosis:
neck mass on straining
radiologic evidence of jugular
dilatation
La Monte, Arch Otolaryngol 1976
Nov;102(11):706-8

Phlebectasia in adults
Superior vena cava
Portal vein
Saphenous vein
Splenic vein
Femoro-popliteal vein
Facial vein
Schatz, N Engl J Med Jan.,1962

Yokomori, Nwako
Muscle layer defects
Thinning of tunica media

Diagnostic Modalities:

Management
1.

Conservative
Advice and reassurance

2.

Surgery
Unilateral resection

Conclusion
Jugular phlebectasia can occur with
bilateral involvement in adults.

Good Morning