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Case Reports
. 2015 Jun;43(3):212-4.
doi: 10.5152/TJAR.2015.82713. Epub 2015 Feb 16.

Absence of the Right Internal Jugular Vein During Ultrasound-Guided Cannulation

Ali Alagöz  1 , Mehtap Tunç  1 , Hilal Sazak  1 , Polat Pehlivanoğlu  1 , Atila Gökçek  2 , Fatma Ulus  1
Affiliations
Case Reports

Absence of the Right Internal Jugular Vein During Ultrasound-Guided Cannulation

Ali Alagöz et al. Turk J Anaesthesiol Reanim. 2015 Jun.

Abstract

Cannulation of the internal jugular vein (IJV) may be diffucult because of anatomical variations. A 66-year-old female patient, who was in the intensive care unit, underwent ultrasound-guided cannulation of the right IJV. The right IJV could not be visualized by ultrasonography despite positional changes of the patient and Valsalva maneuvre. The left IJV was easily determined by ultrasonography and cannulated. Although the landmark technique may be sufficient for most of the central vein cannulations, the rate of anatomical variations and related complications is quite high. We point out that even if ultrasound cannot be used in real-time, the ultrasonographic confirmation during the pre-insertion period may be crucial for successful central vein cannulation.

Keywords: Right internal jugular vein; anatomic variation; complication; ultrasonography.

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Figures

Figure 1
Figure 1
a, b. Ultrasonographic appearance of the right common carotid artery (RCCA) with the absence of the right internal jugular vein. The image was obtained during the Trendelenburg position and Valsalva maneuver. (a) RCCA (b) RCCA with color Doppler imaging
Figure 2
Figure 2
Ultrasonographic appearance of the left common carotid artery (LCCA) and the left internal jugular vein (LIJV)
See this image and copyright information in PMC

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