Link of Video Abstract: https://youtu.be/FZsJ7mtGsW8
Introduction: Superior vena cava syndrome (SVCS) associated with jugular internal vein thrombosis can be dangerous. Diagnosing SVCS and venous thromboembolism (VTE) must be done precisely and accurately to minimize the risk of pulmonary embolism.
Case Presentation: Male, 55 years old, complaining of shortness of breath, the feeling of choking in the neck, and a lump in the neck for one month. The patient has a history of type 2 diabetes mellitus and does not routinely take medication. The patient experienced tachypnea and tachycardia, and there was an enlargement in the submental to the submandibular region; the boundaries were not firm, supple, or fixed, approximately ten centimeters in diameter, and the collateral veins were enlarged and felt pain. Chest examination revealed telangiectasia, crackles, and bronchovesicular breath sounds over both lungs at the base and medial side. The patient had mild anemia and leukocytosis, increased HbA1c levels, total cholesterol levels, and increased D-dimer and Lactate dehydrogenase (LDH). Antero-posterior (AP) lateral cervical radiograph shows a widening of the soft tissue in the retro tracheal space at the level of the second cervix. The patient given warfarin, enoxaparin, methylprednisolone, and heparin. Improvement of the condition was shown.
Conclusion: Superior vena cava syndrome due to internal jugular vein thrombosis is a challenging case. Careful diagnostic measurement based on history and physical examination, in addition of additional investigation may lead to the diagnosis. Management with warfarin, enoxaparin, methylprednisolone, and heparin show clinical benefit.