Diagnostic Imaging of a Child with Congenital Internal

Jugular Vein Phlebectasia

A
10-year-old male child without a history of trauma or differential diagnoses includes laryngocele, bronchial cyst,
inflammation was referred to the Kyushu University cystic hygroma, cavernous hemangioma, and superior medi-
Hospital for a soft and compressible mass in the right astinal cysts.3,4 Adequate imaging tests with Valsalva maneu-
side of the neck during straining. The swelling was not ob- ver should be performed to confirm the diagnosis and the
served at rest, but on Valsalva maneuver, the mass appeared presence of complications. n
in the right side of the neck without pain, bruit, or pulsation.
Ultrasonography and color Doppler flow imaging during
Valsalva maneuver demonstrated local dilatation of the right
internal jugular vein (IJV) without thrombosis (Figure 1). Hazumu Nagata, MD
The intracardiac anatomy was normal. The contrast Kiyoshi Uike, MD
computed tomography of the neck also demonstrated the Yasutaka Nakashima, MD
dilatation of the right IJV without anomaly of other vessels Yuichiro Hirata, MD
(Figure 2; available at www.jpeds.com). Cardiac Kenichiro Yamamura, MD
catheterization was performed while the patient was awake. Toshiro Hara, MD, PhD
A 7F sheath was introduced into the right femoral vein. A Department of Pediatrics
7F balloon catheter (Angio balloon catheter; Cathex, Graduate School of Medical Sciences
Kyushu University
Tokyo, Japan) was maneuvered into the right IJV. There
Fukuoka, Japan
was no significant pressure gradient between the right IJV
and superior vena cava. Angiography showed normal size
References
of the right IJV at rest and significant dilatation of the right
IJV during Valsalva maneuver with buildup of contrast
1. Hung T, Campbell AI. Surgical repair of left internal jugular phlebectasia.
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mm along the longitudinal axis during Valsalva maneuver 2. Hu X, Li J, Hu T, Jiang X. Congenital jugular vein phlebectasia. Am J Oto-
(Videos 1 and 2; available at www.jpeds.com). laryngol 2005;26:172-4.
A fusiform dilatation of the jugular vein is called a phlebec- 3. Shimizu M, Takagi Y, Yoshio H, Takeda R, Matsui O. Usefulness of ultra-
sonography and Doppler color flow imaging in the diagnosis of internal
tasia.1 Congenital internal jugular vein phlebectasia is rare;
jugular phlebectasia. Heart Vessels 1992;7:95-8.
benign disease does not require the surgery unless the lesions 4. El Fakiri MM, Hassani R, Aderdour L, Nouri H, Rochdi Y, Raji A. Con-
are symptomatic.2 However, it is an important differential di- genital internal jugular phlebectasia. Eur Ann Otorhinolaryngol Head
agnosis of the mass of the neck in children. Other possible Neck Dis 2011;128:324-6.

Figure 1. The white arrows show right IJV. The ultrasonography demonstrates local dilatation of the right IJV during Valsalva
maneuver (right) and the normal-sized IJV at rest (left). There is no thrombosis.

J Pediatr 2013;163:1229.
0022-3476/$ - see front matter. Copyright ª 2013 Mosby Inc.
All rights reserved. http://dx.doi.org/10.1016/j.jpeds.2013.04.055

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THE JOURNAL OF PEDIATRICS  www.jpeds.com Vol. 163, No. 4

Figure 2. The black arrows show right IJV. The contrast

computed tomography shows dilatation of the right IJV. There
is no solid mass.

1229.e1 Nagata et al