- 期刊
內頸靜脈擴張症 — 病例報告
Internal Jugular Phlebectasia - Case Report
摘要
內頸靜脈不正常的擴張是一較罕見的症狀。Harris首先於1928年發表第1例，統計至1997年止，約四十例曾於英文文獻發表過。此症狀好發於15歲以前小孩右側頸部，男性較多。患者休息時並無異樣，但進行Valsalva氏手法時，側頸處會明顯鼓出一軟性腫塊。本文報告1名11歲男童主訴於用力時，右側頸部會鼓起明顯腫塊而由父母帶至門診治療。經頸部都卜勒超音波及電腦斷層檢查，發現此腫塊為內頸靜脈不正常的擴張。過去文獻中，對這種症狀常以侵犯性的診斷並進行手術切除來處理，但基於侵犯性診治可能會造成嚴重的併發症，如以長期追蹤來處理，至目前為止文獻上並無任何併發症發表過。因此對此類罕見症狀，利用非侵犯性的都卜勒超音波及電腦斷層來鑑別診斷，加上對病患的長期追蹤，應是一種理想的處理方式。
並列摘要
Abnormal dilation, or phlebectasia, of the internal jugular vein is a rare disorder. The first case was reported in 1928 and only 40 cases have been reported in the English medical literature up to 1997. The characteristic swelling is typically seen on the right side of the neck, typically in male patients over 15 years of age. There are no symptoms when the patient is at rest, but when carrying out a Valsalva maneuver, a conspicuous soft swelling on the lateral aspect of the neck becomes apparent. We describe an 11-year-old boy who was brought to out outpatient department. The chief complaint was a soft mass that swelled up on the right side of the neck during exertion. Cervical Doppler ultrasonography and CT scanning sowed that the soft swelling was caused by abnormal dilation of the internal jugular vein. In the past, the disorder has usually been diagnosed with invasive procedures and then treated with surgical excision. Invasive diagnostic procedures or treatment can potentially result in serious complications, whereas no complications have ever been reported after watchful waiting. Accordingly, non-invasive Doppler ultrasonography and CT scanning for differential diagnosis followed by long term follow-up seem appropriate management for patients with this rare disorder.