Return of the internal jugular vein - development of collateral drainage following neonatal ligation of the vein

The development of collateral venous drainage in the neck of a child, who a s a neonate had undergone ligation and cannulation of the right internal ju gular vein, is described. The resultant vessels were of sufficient calibre to be considered as potential sites for vascular access, although it is pos sible that their course in the thorax may preclude correct placement of a c entral venous catheter. Nevertheless, we feel that this case further illust rates the benefit of hand-held ultrasonography in visualizing the vascular structures of the neck. Moreover, ligation of a vein in the neonatal period should not be a contraindication to subsequent assessment of that site for vascular access.