Spontaneous Thrombosis of above knee perforator veins of the lower limb: A Case Report (original) (raw)

VARICES OF LOWER LIMBS AND THE DIAGNOSIS OF DEEP VENOUS THROMBOSIS: A CASE REPORT (Atena Editora)

VARICES OF LOWER LIMBS AND THE DIAGNOSIS OF DEEP VENOUS THROMBOSIS: A CASE REPORT (Atena Editora), 2022

A clinical case related to Deep Vein Thrombosis (DVT) will be analyzed, having as reference a patient from the Miguel Couto Municipal Hospital (HMMC) in the city of Rio de Janeiro. Patient with edema, hyperemia and pain in the right lower limb. It evolves with increased edema and hyperemia, associated with intense pain. Biochemical and imaging tests with Doppler ultrasonography of the lower limbs, in addition to D-dimer, resulted in a diagnosis of Superficial Venous Thrombosis (SVT) and differential diagnosis of DVT. The saphenectomy procedure and guidance for the use of compression stockings were performed in order to prevent the formation of new thrombi.

Concomitant acute deep venous thrombosis and superficial thrombophlebitis of the lower limbs

Medical ultrasonography, 2011

Some patients may have deep venous thrombosis (DVT) and superficial thrombophlebitis (ST) of the lower limbs at the same time. To analyze the frequency of risk factors for thrombosis (RF), other than thrombophilias, in patients with concomitant DVT and ST. Clinical examination, plasma D-dimers and duplex ultrasonography were performed in 88 consecutive patients (mean age 64.9 +/-13.9 years) admitted in Medical Clinic in 2007. Patients with DVT were divided into two groups: A (with ST - 30 subjects, 34.1%) and B (without ST - 58 patients, 65.9%). Conditions known as RF were the following (Group A versus B): varicose veins (17 vs 21 patients, p=0.11), obesity (12 vs 19, p=0.66), previous venous thromboembolism (8 vs 16, p=0.87), malignancy (4 vs 10, p=0.44), chronic obstructive lung disease (4 vs 7, p=0.56), sepsis (2 vs 3, p=0.56), stroke and chemotherapy (1 vs 2, p=0.73), bed rest more than three days (1 vs 7, p=0.17), major surgery (1 vs 1, p=0.57), family history of DVT (1 vs 0, p...

Spontaneous hemorrhage from varicose veins: A single-center experience

Journal of Vascular Surgery: Venous and Lymphatic Disorders, 2020

Objective: Whereas the commonly described manifestations of venous insufficiency include telangiectasia, varicose veins (VVs), edema, skin changes, and ulcers, we have noted some patients who present with external hemorrhage from lower extremity VVs. Because there are few recent data examining this entity, we herein describe our experience. Methods: During 29 months, we had 32 patients present with hemorrhage from lower extremity VVs. There were 15 men and 17 women with a mean age of 60.2 years (range, 38-89 years; standard deviation [SD], 614.9 years). Interestingly, 16 of these patients presented after coming into contact with warm water; 28 patients, 19 patients, and 1 patient presented with reflux >500 milliseconds in the great, small, and accessory saphenous veins, respectively. Eight patients and six patients had reflux >1 second in the femoral and popliteal veins, respectively. Results: All patients were treated with weekly Unna boots. Mean ulcer healing time was 2.12 weeks (range, 1-8 weeks; SD, 6 2.15 weeks). Patients with VV hemorrhage after contact with warm water had a mean healing time of 1.75 weeks, whereas those who bled without such exposure took an average of 3.5 weeks (P ΒΌ .0426). Twenty patients underwent at least one endovenous thermal ablation procedure, with the average patient in the cohort receiving 2.16 procedures (range, 0-9; SD, 6 2.37). There was no significant difference between laterality, age, or sex between patients who bled after warm water contact and those who bled spontaneously. The ulcers recurred in three of the patients, and Unna boot treatment was reapplied until wounds healed once more. Patients had an average follow up of 7.2 months (range, 26 months; SD, 6 8.9 months), and we noted no recurrent bleeding episodes. Conclusions: Spontaneous hemorrhage of VVs, although relatively under-reported, is not a rare occurrence. Risk factors are unknown; however, half of our patient cohort reported VV hemorrhage during or directly after coming into contact with warm water. Furthermore, these patients demonstrated a significantly shorter wound healing time compared with the rest of the cohort. Basic first aid, wound care, and hemostasis control education should be provided to all patients with VVs. Further investigation surrounding the risk factors associated with VV hemorrhage is warranted.

Management and outcome of lower limb varicose veins: a hospital based follow up study

Background: Disorders of veins which are chronic in nature and very common are the varicose veins. Surgery is required at any one stage of the disease. There have been considerable advances that took place in the diagnostics of the varicose veins, but the treatment outcomes may not be good in many cases. To study the management and outcome of lower limbs varicose veins. Methods: This was a hospital based follow up study. Patients who presented with varicose veins signs and symptoms were included. During the study period it was possible to include 40 patients who were willing to get included in the present study. Various presentations, complications and treatments were noted and finally followed up for minimum of 3 months. Results: Most commonly affected age group was 36-45 years. Males were four times more affected than females. Most commonly affected limb was left side in 48%. Long saphenous system was involved in 55%. The predominant symptom was dilated and tortuous veins (32%) followed by pain (25%). 65 incompetent perforators identified by clinical examination and 130 by Doppler with above ankle being the commonest incompetent perforator. With the mean follow up of six months, no serious complications were noted. It was found that the sensitivity of the clinical examination was 82% when doppler scan was taken as gold standard. On follow up no one developed deep vein thrombosis. Incompetence recurrence rate at SFJ was 8% and at SPJ was 18%. Conclusions: We conclude that surgery is the first line of management and if done accurately, complications are minimal.

A Clinico Epidemiological Study of Varicose Veins

IOSR Journals , 2019

Background and objectives: Venous diseases of lower limb remain commonaffecting 20% of adult population. Objective of this study is to identify cases with primary varicose veins, evaluate with appropriate investigations, collect data and establish the clinical spectrum of complications in this population. Methods: Study was conducted on 50 consecutive patients with primary varicoseveins at Govt. thiruvarur medical college, thiruvarur. All cases of varicose veins presenting to the OPD were subjected to duplex scan to rule out secondary causes. Patients admitted with varicose veins who satisfied the inclusion and exclusion criteria were included in the study.. Patients who presented with bilateral disease got their symptomatic limb operated first while the other limb was treated conservatively Patients with saphenofemoral incompetence were treated with saphenofemoral junction ligation and stripping of long saphenous vein. Patients with saphenopopliteal junction incompetence were treated with saphenopopliteal junction ligation with or without stripping of short saphenous vein. Patients with perforator incompetence were treated with subfascial ligation of perforators Results: Out of 50 patients studied, 39 (78%) patients were agriculturists, whoadmitted of having been exposed to prolonged hours of standing .Among the 50 cases studied, 70 limbs showed varicose veins, of which 32 limbs had long saphenous vein and communicating system involvement (45.7%). 20 limbs had long saphenous vein involvement (28.5%) alone. Among 32 limbs with long saphenous and communicating system involvement, 24 had pain (75%), 7 had oedema (21.8%), 18 had disfigurement (56.2%), 8 ulcers (25%). Among 20 limbs with only long saphenous involvement 10 had pain (50%), 3 had oedema (15%), 4 had disfigurement (20%), 2 had ulcer (10%).Of the 48 limbs that underwent surgery 26 (54.1%) underwent saphenofemoral flush ligation with stripping of LSV and subfascial ligation of perforators Conclusion: Definite relationship exists between occupation involving prolongedstanding and primary varicose veins.The involvement of long saphenous and communicating system together is commonest followed by long saphenous involvement alone. Patients with involvement of long saphenous and communicating system or long saphenous and short saphenous system were more symptomatic than others Complications of varicose veins were responded well to operative treatment. Results of surgical treatment are good

Clinicoetiopathological Study of Varicose Veins at a Tertiary Care Centre

Journal of Evidence Based Medicine and Healthcare, 2019

BACKGROUND Varicose veins, though a common condition, many a times remains asymptomatic. During its course, the disease produces complications which usually make the patient to seek medical care. METHODS This is a prospective study where 100 patients with varicose veins admitted in Department of General Surgery, SVRRGGH Tirupati, were evaluated. A thorough history was obtained, detailed clinical examination was done, and clinical tests were applied; patients were subjected to duplex USG to confirm the diagnosis. Routine investigations were done, and patients underwent treatment based on clinical and investigational profile. The post-operative course, follow-up was noted. The final outcome was evaluated by the information that was taken down in the proforma designed for the study. RESULTS Majority of the patients were in the middle age group and incidence is more in males. Great saphenous system involvement is more common, and the operative procedure performed commonly is SFJ flush ligation with stripping of LSV with incompetent perforator ligation. CONCLUSIONS Majority of the patients presented with combined perforator and SF incompetence. Surgical treatment with flush ligation and stripping of LSV appears to be best option for lower limb varicose veins with LSV truncal involvement.