Case 40: Chronic Venous Insufficiency - Varicose Veins - Venous Thrombosis

       

Clinical Features:

A 52 years old male patient came with

- Left leg pain

- Dilated superficial veins with overlying skin discoloration

Ultrasound Features:

- Bilateral severely incompetent sapheno-femoral & sapheno-popliteal junctions along with dilated incompetent left leg perforators suggest chronic venous insufficiency.

- Dilated & tortuous superficial veins along both long & short saphenous territories of the left lower limb, more prominent below the knee indicate varicose veins.

- Heterogeneous low-level echoes within a dilated tortuous, non-compressible posterior thigh tributary of the left long saphenous vein suggest venous thrombosis. 

- No deep venous thrombosis.

- Prominent left inguinal lymph nodes.

Remember:

In case of long-standing varicose veins, thrombus within superficial & deep veins is not uncommon.

Ultrasound Images:

 

Fig: Severely incompetent right sapheno-femoral junction

Fig: Severely incompetent right sapheno-popliteal junction

Fig: Severely incompetent left sapheno-femoral junction

Fig: Severely incompetent left sapheno-popliteal junction

Fig: Left Long saphenous vein

Fig: Left Long saphenous vein

Fig: Dilated left leg perforator vein

Fig: Incompetent left leg perforator vein with bidirectional flow

Fig: Varicose veins along the left leg short saphenous territory 

Fig: Dilated left leg short saphenous vein

Fig: Lt: Varicose veins along the left leg short saphenous territory

Rt: Posterior thigh varicose vein with thrombus

Fig: Left leg varicose veins along the long saphenous territory

Fig: Left posterior thigh varicose veins with thrombi

Fig: Left posterior thigh varicose vein, a tributary of LSV with thrombi

Fig: Left posterior thigh varicose vein, a tributary of LSV with thrombi

Fig: Left posterior thigh varicose vein, a tributary of LSV with thrombi

YouTube Video Link:

https://youtu.be/mAKkOSCWFv0