# A Rare Anastomosis Between the Internal and the External Jugular Veins: A Case Report

## TL;DR

A rare connection between two neck veins was found during surgery, which could impact medical procedures in that area.

## Contribution

The paper reports a rare anatomical variation of jugular vein anastomosis with clinical implications.

## Key findings

- A 1 cm long anastomosis was found between the internal and external jugular veins at the cricoid cartilage level.
- The anastomosis had a 0.3 cm diameter and no obstruction, with blood flow from IJV to EJV.
- The variation is clinically important for procedures like hemodialysis catheter placement and neck surgeries.

## Abstract

Usually, the external jugular vein (EJV) is located superficially over the sternocleidomastoid muscle and joins the subclavian vein or the venous angle. The internal jugular vein (IJV) lies deeply in close relation with the common carotid artery and vagus nerve, enveloped by the carotid sheath. Normally, there is no direct connection between those vessels. During a routine neck dissection, we found a rare anastomosis between IJV and EJV. The anastomosis was localized on the level of the cricoid cartilage. It was approximately 1 cm long, with the diameter of the lumen being 0.3 cm. There was no obstruction along the length of the vessel. The direction was oblique and followed the blood flow from IJV to EJV. The observed variation has high clinical importance related to numerous procedures executed in the neck region, such as placement of hemodialysis catheter in patients with renal failure, insertion of central venous line in the care of critically ill patients, and radical neck dissections.