Thrombophlebitis of the internal jugular vein after tonsillectomy

Abstract

Introduction Thrombophlebitis of the internal jugular vein may appear as a rare complication of oropharyngeal infection and tonsillectomy procedure. Clinical features usually include an acute onset of inflammation with formation of venous thrombosis and secondary septic propagation (Lemierre’s syndrome). The aim of this work was to present a rare case of internal jugular vein thrombophlebitis as a late complication following tonsillectomy.

Case outline We present an otherwise healthy 25-year-old male patient on whom tonsillectomy was performed due to chronic tonsillitis. Two weeks after surgery, the patient was rehospitalized for high temperature, diffuse swelling on the left side of the neck, fatigue, painful swallowing, and constrained mouth opening. Thrombophlebitis of the left internal jugular vein was diagnosed by the neck ultrasound. Complete recovery was achieved in three weeks’ time by the combination of antibiotics and anticoagulant/antithrombotic therapy.

Conclusion Tonsillectomy is a risk factor for the internal jugular vein thrombosis in adults with chronic tonsillitis, especially if fibrous adhesions are expected or found during the surgical procedure.

Keywords: Lemierre’s syndrome; tonsillectomy, complication; venous thrombosis, etiology, diagnosis, therapy