Venous Bypass for Treatment of Chronic Venous Stasis Ulcers

Objectives: Venous aneurysms in the neck are rare, and spontaneous aneurysms of the external jugular vein (EJV) are particularly unusual.Although these aneurysms are infrequent, they present a potential risk for complications such as thrombosis, embolism, or rupture.Typically arising from a weakness in the venous wall, these aneurysms can be triggered by external factors like trauma or inflammation or systemic conditions such as connective tissue disorders.Clinical presentations range from a painless, pulsatile mass to more severe symptoms like neck pain, dysphagia, or respiratory distress, depending on the aneurysm's size and location.Proper diagnosis and management are essential to mitigate potential complications.This case report documents a unique instance of a spontaneous EJV aneurysm.It details the patient's presentation, diagnostic imaging, intraoperative findings, and outcome.Methods: A 68-year-old female presented with a gradual onset swelling on the right side of her neck over the past 5 months.The swelling progressively increased in size and was associated with dull, aching pain over the past 2 months.The pain was aggravated by activity involving the right upper limb and was relieved by medication.Notably, there was no history of trauma, cannulation, ICU admissions, breathlessness, or prior neck procedures.Additionally, there was no family history of connective tissue disorders.On examination, a 4 4 cm swelling was noted in the lower one-third of the anterior aspect of the neck within the muscular triangle.The swelling had a smooth surface, cystic consistency, well-defined margins, was mobile horizontally but restricted vertically, compressible, and demonstrated a mild impulse on coughing.A CT venogram of the neck revealed a saccular aneurysm originating from the right external jugular vein.Following informed consent, the patient underwent ligation and excision of the right EJV pseudoaneurysm under general anesthesia.Intraoperatively, after incising the skin and platysma, a 3 2 cm aneurysm with a 1.5-cm neck was identified on the right EJV.The vein was ligated proximally and distally, and the aneurysm was excised.Results: Postoperative follow-up indicated complete resolution of the pain.This case underscores the importance of recognizing and managing uncommon venous aneurysms in the neck, as well as the successful outcome following appropriate surgical intervention.Conclusions: Spontaneous aneurysms of the external jugular vein are rare but can have varied presentation and complications.This case report