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Internal Jugular Vein Rouleaux Flow on POCUS Amazing video of a dilated IJV showing Rouleaux flow. Whenever the blood flow slows down significantly, it causes the RBCs to clump together and they become echogenic as in this case. Always look for underlying cause. Ria Dancel, MD @ria_dancel #Rouleaux #Flow #Internal #Jugular #IJ #Vein #POCUS #vascular #clinical #Spontaneous #Contrast