Table of Contents
Learn the focussed examination too…
Varicose veins focussed examination covered here!
Varicose veins are tortuous, dilated veins of the superficial venous system.
- Incompetent valves in perforating veins cause retrograde blood flow from the deep to superficial veins of the leg
- This results in increased pressure and dilation of the superficial veins
- Most are asymptomatic except for aesthetic problems but patient may have pain, cramps, heaviness, tingling and restless legs
- Varicose eczema
- Venous ulcers
- Haemosiderin deposits
- Lipodermatosclerosis (subcutaneous fibrosis due to chronic inflammation and fat necrosis)
- Atrophie blanche (white scarring around healing ulcer)
- Colour flow duplex ultrasound
- Refer if: bleeding, pain, ulceration, thrombophlebitis, severe impact on quality of life
- Management options
- Conservative: avoid prolonged standing, graduated compression stockings (if no peripheral arterial disease), regular walking, weight loss
- Injection sclerotherapy: sclerosant injected at multiple sites in varicosities
- Phlebectomy: stab avulsion or mechanical avulsion
- Endovenous laser ablation
- Radiofrequency ablation
- Surgical stripping
Here are some questions
What is a saphena varix?
What are the risk factors for varicose veins?
What is Trendelenburg test and how is it performed?