A case of rupture of the internal jugular vein caused by postoperative infection of functional neck dissection.
A 68-year old diabetic man with gingival cancer of the lower jaw underwent resection of the mandible and functional neck dissection. Swabs of a postoperative wound infection revealed methicillin-resistant Staphylococcus aureus (MRSA). The wound was irrigated, and antibiotics administered. The pathogens isolated were sensitive to the antibiotics used, but the infection failed to respond to treatment. Bleeding ensued on the 14th postoperative day (#14POD), when the wound was opened to reveal thrombosis and rupture of the right internal jugular vein. The patient's condition improved after ligation and surgical debridement of the right internal jugular vein. Our experience underlines the importance of early radiological investigation for possible thrombus formation in the internal jugular vein in cases of postoperative wound infection follows functional neck dissection with conservation of the internal jugular vein. It is also important to actively treat this condition surgically, including ligation of internal jugular vein for suppressing inflammation.
Ota
Y
Y
Department of Oral Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan. yota@is.icc.u-tokai.ac.jp
Aoki
T
T
Karakida
K
K
Miyasaka
M
M
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005887:Gingival Neoplasms / Q000601:surgery*; D006801:Humans; D007601:Jugular Veins / Q000293:injuries*; D008197:Lymph Node Excision / Q000009:adverse effects*; D008297:Male; D016106:Methicillin Resistance; D012421:Rupture / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D013211:Staphylococcus aureus / Q000502:physiology; D013530:Surgical Wound Infection / Q000150:complications*; D013927:Thrombosis / Q000209:etiology
D000900:Anti-Bacterial Agents