Internal jugular vein thrombosis associated with venous hypoplasia and protein S deficiency revealed by ultrasonography

Byung Gun Lim, Young Min Kim, Heezoo Kim, Sang Ho Lim, Mi Kyoung Lee

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


A 41-year-old woman, who had no thrombotic risk factors and past history except congenital scoliosis, underwent central venous catheterization (CVC) before correction of the scoliosis. When internal jugular vein (IJV) catheterization using the anatomical landmark technique failed, CVC under ultrasound guidance was tried. As a consequence, thrombosis and hypoplasia of the right IJV were incidentally detected by ultrasonography. Central venous catheters were then successfully placed in other veins under ultrasound guidance. Also, after examinations to rule out the possibility of pulmonary embolism and to clarify the causes of the IJV thrombosis, the patient was found to have protein S deficiency. CVC under ultrasound guidance should be recommended to prevent the failure of cannulation and complications such as thromboembolism in patients who could possibly have anomalies of vessels as a result of anatomical deformities caused by severe scoliosis, even if patients do not have thrombotic risk factors such as a history of central catheter insertion or intravenous drug abuse, cancer, advanced age, cerebral infarction, and left ventricular dysfunction. Also, if venous thrombosis is found in patients without predisposing risk factors, one should ascertain the cause of the hypercoagulable state, for example protein S deficiency, and perform appropriate treatment and prevention of venous thromboembolism.

Original languageEnglish
Pages (from-to)930-934
Number of pages5
JournalJournal of Anesthesia
Issue number6
Publication statusPublished - 2011 Dec
Externally publishedYes


  • Protein S deficiency
  • Ultrasonography
  • Venous hypoplasia
  • Venous thrombosis

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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