Venous Diseases Important Question And Answers

Venous Diseases

Question 1. Write a short note on complications of varicose veins with reasons.

Answer. Varicose veins are dilated and tortuous, superficial veins predominantly in the lower limbs. Varicose veins are the price that man has to pay for erect posture.

Varicose Complications

• Eczema and dermatitis: This occurs because of extravasation and breakdown of RBCs in the lower leg.
  • It leads to itching which precipitates varicose ulcer.
  • This condition is treated by the application of zinc oxide cream or silver sulfadiazine cream (stasis dermatitis).
• Lipodermatosclerosis: It refers to various skin changes in the lower leg associated with varicose veins such as thickening of subcutaneous tissue, indurated feel like wood, pigmentation, etc.
• It occurs because of increased venous pressure resulting in capillary leakage with extravasation of blood and firing into surrounding tissues. Blood is broken down and heme is released.
• This combines with iron giving rise to hemosiderin which is responsible for pigmentation. Classically, this affects the gaiter area of the leg just above the malleoli.

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• Hemorrhage: It occurs due to trauma or eczema. This is controlled by elevation of the leg and crepe bandage.
• Thrombophlebitis: It refers to the inflammation of a superficial vein. In this vein is tender, hard, and cord-like.
  • Her skin is inflamed and pyrexia is usually present. It is treated by bed rest, elevation, crepe bandage, antibiotics and anti-inflammatory drugs.
• Venous ulcer: It is also called gravitational ulcer. Precipitating factors are venous stasis and tissue anoxia.
  • Deep vein thrombosis is also an important cause of venous ulcers where in valves is either destroyed or incompetent due to damage.
  • Sustained venous pressure results in extravasation of cells, activation of capillary endothelium resulting in release of free radicals.
  • These free radicals cause tissue destruction and ulceration.
• Calcification: This is seen inside the walls of vein.
• Periostitis: It may occur in tibia because of the ulcer present on the medial surface of leg.
  Due to involvement of periosteum ulcer leads to severe pain.
• Equinovarus deformity: It occurs due to improper habit of walking on toes which leads to shortening of tendo Achilles.
• Marjolin’s ulcer: It is the squamous cell carcinoma which arises from healed varicose ulcer with scarring.