Internal jugular phlebectasia

Abstract

Varicose veins are a common venous anomaly, but rarer varieties also occur including phlebectasia, which is an abnormal dilatation of an isolated vein. Phlebectasia may affect any vein and is usually asymptomatic. When the internal jugular vein is involved, it presents as a cervical swelling that closely mimics the signs of either a pharyngocoele or a laryngocoele and, due to its rarity, is frequently misdiagnosed. A review of the English literature demonstrates that the diagnosis has generally been confirmed either by invasive contrast radiographic techniques, or surgical exploration, though many authors had made a tentative clinical diagnosis prior to surgical confirmation. No treatment is indicated for this benign self-limiting condition, except for the few patients who complain of symptoms and require surgical removal of the affected vein, and therefore, if a diagnosis cannot be made with certainty from the clinical features, investigations should be as non-invasive as possible, employing either a CAT scan or Digital Subtraction Angiography, though the latter is not yet universally available.