The Importance of the Angulation and Termination of External Jugular Vein in Central Venous Catheterization in Newborn

Abstract

The purpose of this study is to evaluate the termination and angulation of the EJV (External jugular vein) and the number and the position of its valves so as to improve our understanding of the anatomy of the EJV and to make the manuplation easier in central venous catheterization in newborn. The present study was carried out on 50 newborn cadavers (31 male, 19 female). 100 Dissections were bilaterally made. The angle of the termination of the EJV was measured. Its termination angle was also radiologically measured. Its termination was classified into three types: In 72 cases (72%), EJV flowed into the jugulo-subclavian venous confluence; in 26 cases (26%), into the SC V (Subclavian vein) at a distance (1cm) from its junction with the IJV (Internal jugular vein); in 2 cases (%2) into the trunk of the IJV. Its termination types were asymmetrical in 12 cadavers (24%) and symmetrical in 38 (76%). Its termination angle was found both anatomically or radiologically to be within 25°-60°. The valves of the EJV were examined in 10 newborn cadavers. They were most often bi-valvular, in paraostial position and were of a membranous character. It is important to remind the physician about the surprises related to its terminations and angulations during the central venous catheterization.