Author(s): Taylor Blackwood, Alfred Laborde, Cara L Fisher
Background: Variations in the drainage of the external jugular vein (EJV) are uncommon. We report a rare case of unilateral left EJV
drainage that coursed superficial to the left clavicle and then proceeded to drain into the left subclavian vein.
Case Information: During routine dissection of a 70-year-old African-American male cadaver, a unilateral variation in the left external
jugular vein was noted. The typical left EJV path courses posterior and deep to the clavicle before draining into the left subclavian vein. This
variant EJV was found to descend superficial to the middle third of the left clavicle and then proceeded to drain into the left subclavian vein.
Conclusions: Anatomical variations of the EJV may pose certain health risks and increase the complexity of various surgical procedures. The
EJV is commonly used as an indicator for increased central venous pressure which can be used concordantly with other symptoms during cardiac
workup. Knowledge of the EJV and its common variants is important for clinicians and surgical specialists alike. Surgeons performing placement
of pacemaker leads or implantable cardioverter defibrillators should be acutely aware of the EJV and its variants to reduce complications and
improve patient outcomes. Patients and individuals possessing this EJV variation may be at increased risk of adverse outcomes in the event
they were to fracture their clavicle. The clavicle is the most commonly fractured bone in the body and the middle third is the most fractured
segment, where this variant was noted. Notching of the clavicle was noted where the EJV passed superficial to it. We postulate this may be due
to increased pressure from its tortuous path, as well as aberrant development due to the mobility of the clavicle.