Internal jugular vein thrombosis following ovarian hyperstimulation syndrome
Department of Obstetrics and Gynaecology, St George Hospital, NSW, Australia.Australian and New Zealand Journal of Obstetrics and Gynaecology (Impact Factor: 1.51). 02/2012; 52(1):87-90. DOI: 10.1111/j.1479-828X.2011.01392.x
Two cases of women who developed internal jugular vein (IJV) thrombosis associated with ovarian hyperstimulation syndrome (OHSS) are reported in this article. There are 27 cases of IJV thrombosis associated with in vitro fertilisation (IVF) reported in the literature, and in 78% of cases, this outcome was following OHSS. The hypercoagulable state of OHSS increases the risk of venous thromboembolism, and the IJV appears to have a preponderance in uncommon-site thrombosis. © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.
Chapter: Jugular Vein Thrombosis[Show abstract] [Hide abstract]
ABSTRACT: Jugular vein thrombosis (JVT) is a not uncommon and serious finding encountered by radiologists. While identifying thrombus within the internal jugular vein (IJV) is usually not a diagnostic dilemma, a thorough evaluation of the surrounding structures is critical due to the sundry etiologies, potentially devastating complications (including pulmonary embolism, septic emboli, and dural sinus thrombosis), and high association with neoplasm. In this chapter, we discuss the typical anatomy of the IJV and the pathophysiology, clinical presentation, and potential etiologies of JVT (including iatrogenic, neoplastic, infectious, traumatic, hematologic, rheumatologic, gynecologic, endocrine, and idiopathic causes, as well as pediatric-specific considerations). Multimodality imaging findings of JVT (computed tomography, magnetic resonance imaging, ultrasound, nuclear medicine, and angiography) and the diagnostic pitfalls are also reviewed, utilizing an image-rich, comprehensive review of the medical literature.
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ABSTRACT: A 30 years multiparous female with history of emergency caesarean section 10 days back was referred to us with cough, severe breathlessness at rest, orthopnea with pain in neck and arms. Clinical examination revealed signs of heart failure. Echocardiography showed ejection fraction of 15%, with no right ventricular strain. A diagnosis of peripartum cardiomyopathy was made. Doppler ultrasound of neck veins showed bilateral internal jugular vein thrombosis. Subsequent multislice CT examination showed thrombosis of superior vena cava and both internal jugular veins (with collateral formation) and pulmonary embolism. There were no mediastinal abnormalities on the CT scan. Her thrombophilia screen and CT scan brain was normal. She was managed in collaboration with cardiologist. Following treatment with subcutaneous enoxaparin therapy and warfarin her symptoms of upper limb pain improved. She responded very well to medical therapy for heart failure with marked improvement of NYHA functional class.
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