Variations in Anterior Jugular Venous Drainage and Their Clinical-Surgical Relevance: A Case Report

The anterior jugular venous system is known for its marked anatomical variability, with descriptions of its variations dating back to early anatomical studies. A thorough understanding of these variations is essential for clinicians performing invasive procedures in the anterior cervical region. During a routine dissection at the Department of Anatomy, Faculty of Medicine, University of the Republic in Montevideo, Uruguay, an atypical anterior jugular venous configuration was encountered. This case was notable for the presence of numerous venous trunks, all ultimately draining into the right subclavian vein. The dissection focused on the anterior cervical region, with detailed examination of each component of the anterior jugular venous system and their respective terminations. The subject was an 80-year-old cadaver weighing approximately 45 kg, previously preserved in formaldehyde. Standard surgical instruments were used for the dissection, measurements were obtained with an electronic caliper, and photographic documentation was performed using a Nikon D500 camera. The dissection revealed multiple anterior jugular venous trunks: three on the right and two on the left. These vessels originated from various sources, including the external jugular vein, facial vein, thyrolinguofacial venous trunk, and submental veins. All ultimately converged to form a common trunk draining into the right subclavian vein. Anatomical variations of the anterior jugular system are frequent and can pose challenges during clinical and surgical procedures involving the cervical region. Awareness of such variants is critical to minimize the risk of iatrogenic injury, particularly during the placement of central or peripheral venous catheters or surgical approaches such as the presternocleidomastoid route. This case underscores the importance of detailed anatomical knowledge in ensuring safe and effective interventions in the neck.