video:image clot

Video of the Week: Internal Jugular Vein Clot

Dr. Duneant, PGY-2 EM resident at HUM, found this clot in the right IJ of a patient in the ICU.  The patient had signs and symptoms highly suggestive of a pulmonary embolism however sonographic DVT studies were negative bilaterally.  The probe was placed over the right IJ in anticipation of placement of a central line.

Here is the normal left IJ for comparison:

And another investigation of the right IJ:

The patient was appropriately started an anticoagulation.  Great find!  And another reminder of how helpful ultrasound is in diagnosing disease and guiding procedures.  Good thing the procedure wasn’t performed blind!

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