Nonsurgical Management of Traumatic Internal Jugular Vein Rupture Using Direct Compression

Abstract

A 67-year-old male presented to the emergency department with left neck pain and swelling after meeting with a traffic accident. The neck computed tomography (CT) revealed a multifocal contrast media extravasation from the left internal jugular vein (IJV) and a severe mass affecting the diffuse soft tissue infiltrating and thickening the deep cervical and superficial cervical spaces (Fig. 1). The left cervical portion was compressed with a sand bag (Fig. 2). The patency of both IJV was confirmed in the neck ultrasound on the following morning (Fig. 3). One week later, follow-up CT revealed total recanalization of the occluded left IJV, marked absorption of preexisting hematoma located in the deep neck spaces, and a bulging caused by liquefaction of the resolving hematoma in the left masticator and posterior cervical space (Fig. 4). The left IJV, not found in threedimensional angiographic images in the neck CT, was observed again after 1 week (Fig. 5).