A RARE CASE OF PRIMARY UEDVT AND CVT IN PREGNANCY

Abstract

Upper extremity deep vein in thromboses (UEDVT) is rare. In UEDVT, Internal jugular vein thrombosis (IJVT) is a serious event with a potentially fatal outcome. Complications include pulmonary embolism, sepsis with  septic emboli to different organs and tissues as well as intracranial propagation of the thrombus with cerebral edema. As any thrombosis, Internal Jugular Vein Thrombosis is  precipitated by Virchow's triad endothelial damage, alteration of blood flow and hypercoagulability. The history and  examination in patients with an Internal Jugular Vein  Thrombosis may be vague and misleading. Patients may present with a painful swelling of the neck but they may also be absolutely asymptomatic. The prevalence of CVT in Indian population is about 4.51000 obstetric admissions with a case fatality rate of less than 10. CVT associated with pregnancy and puerperium has a more acute onset and better prognosis than thrombosis due to other causes. Imaging procedures frequently used to diagnose an Internal Jugular Vein   Thrombosis include sonography with color-coded duplex sonography, computed tomography, magnetic resonance imaging as well as magnetic resonance venography. Since the advent of newer imaging techniques angiography and other contrast studies are rarely necessary to diagnosis  sinovenous thrombosis as angiography is associated with significant complications like thrombosis, risk of propagating infection intracranially in septic thrombophlebhitis, time  consuming and cumbersome. Potential pitfalls of angiography include mixing of contrast and unopacified blood from the hemisphere opacification of intradural collaterals which may mimic filling of sinus. Up to date, there is no standardized treatment regimen for patients with an Internal Jugular Vein Thrombosis.