Syn.: Varices.
Def .: Disease dilatation of superficial veins resulting from the imbalance between the mechanical resistance of the venous wall and the increased blood pressure pressing against this anatomical structure.
Epid .: From 0,2% of the population in New Guinea to over 50% in European countries. Due to their parentage, women are more predisposed to the occurrence of varicose veins. It occurs all over the world.
Etiol .: Chronic inflammatory process of the venous wall and valve leaflets. Congenital defect concerning the structure of the venous wall, the valve apparatus of the veins or the anatomical structure. Predisposing factors:
– pregnancy,
– physical work in a standing position,
– excessive effort of the muscles of the lower limbs (in professional athletes or amateurs),
– obstruction of the outflow of venous blood due to iatrogenic causes (ligation of veins during surgery, catheterization of large veins in infancy), disease (pressure of the proliferative tissue on the venous structures),
– the reverse flow of blood under the action of the force of gravity, possible due to regurgitation or damage to the venous valves,
– deep vein thrombosis or congenital septum and narrowing inside large veins,
– cirrhosis of the liver – hypertension in the portal vein system.
Loc .: Mainly the lower limbs, but also the esophagus, the internal organs of the abdominal cavity, the final section of the gastrointestinal tract.
Klin .: Anatomically picture of twisted and widened veins with a thin wall. The skin above and around the varicose veins may be brown in color. It may be accompanied by secondary skin allergy located mainly in the vicinity of one meter. They do not always cause pain. Often there are accidental scratches that are caused by itchy skin. Accidental trauma or scratching may cause bleeding from varicose veins, and may pose a risk of significant bleeding (if it occurs at night during sleep).
Hist .: Histologically – significant accumulation of collagen tissue in the venous wall of varicose veins leads to the destruction of the muscular and elastic elements. This weakens the mechanical resistance of the venous wall.
DL: Physical examination, USG-color-Doppler.
DR: It is important from the point of view of differential diagnosis whether varicose veins are not part of the replacement circulation as a result of massive thrombosis of the main outflow veins from a given area of the body. Removal of varicose veins in such a case would be a malpractice.
But: Treatment consists in excluding varicose veins from the circulation. This may include excision, ligation, or intravascular occlusion (laser, radio waves, sclerotherapy).
Year: Good. Relapses occur between 40% and 60% within 5-10 years of follow-up.
DIG. W-1. Anterolateral varicose veins of the thigh.
DIG. W-2. Varicose veins.
Lit .: [1] Murad Alam, Tri H. Nguyen: Treatment of diseases of the veins of the lower extremities. Kaszuba A. (ed. Polish edition), Wyd. Elsevier Urban & Partner, Wrocław 2008. [2] Rybak Z .: Varicose veins of the lower limbs. Health Service 2002, 15-18 (3111- 3114); 29-33. [3] Rybak Z., Szyber P., Dorobisz AT et al. Compensated and decompensated hemodynamics of venous circulation in the lower limbs. Therapy, 2000, 8 (93); 31-3.
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House