Varicose vein is one of the ancient diseases, which has its evidence in Greek sculpture. Nowadays varicose vein has become a popular disease because of the media, so that many people want to treat their varicose vein and many medical doctors from a variety of fields seek a varicose clinic, accordingly. Since the introduction of the great saphenous vein stripping, the treatment of varicose vein has not been changed very much for about 100 years. Recently, however, many doctors in the outpatient varicose clinic prefer less invasive treatment and some innovative techniques that have become available recently. Endovascular treatment or transilluminated powered phlebectomy is one of them. Some dermatologists try to treat all kinds of varicose vein with sclerotherapy. But the long-term results of the treatment reveal that the gold standard of the treatment of typical varicose vein is a groin-to-knee inversion stripping of the great saphenous vein with stab avulsion of the varicose cluster. The application of the color Doppler duplex ultrasonogram to the leg vein has made it possible to evaluate the reflux of axial veins and perforator veins more thoroughly and less invasively. Therefore ultrasonography is the method of choice for the diagnosis of varicose vein preoperatively and postoperative follow-up studies for recurrent cases. The recurrence of varicose vein after treatment is mostly from the remnant reflux in the saphenofemoral junction and its tributary. Thus more meticulous treatment of the tributaries of saphenofemoral junction is needed.
Diagnosis ; Follow-Up Studies ; Humans ; Leg* ; Outpatients ; Recurrence ; Saphenous Vein ; Sclerotherapy ; Sculpture ; Ultrasonography ; Varicose Veins* ; Veins

BACKGROUND: We observed several cases of rare vascular anomalies within the femoral triangle during varicose vein operations. METHODS: From among 2,093 patients who underwent stripping operations of the great saphenous vein between January 2002 and June 2016, 14 cases of rare vascular anomalies were enrolled in this study. RESULTS: Twelve cases of femoral artery and vein transposition (0.57%), 1 case of separate entrance of the great saphenous vein trunk and its tributaries (0.05%), and 1 case of separate entrance with femoral artery and vein transposition (0.05%) were observed. The preoperative diagnosis rate was 71% (10 of 14) using duplex ultrasound. In all cases of femoral artery and vein transposition, the saphenofemoral junction was located at the lateral or posterolateral side of the superficial femoral artery, corresponding to complete or incomplete transposition, respectively. Among the 12 cases of femoral artery and vein transposition, 5 cases were complete transposition and 7 cases were incomplete transposition. In 2 cases of separate entrance of the great saphenous vein trunk and its tributaries, the separated tributaries formed a common trunk before connecting to the femoral vein. CONCLUSION: The anatomy of the saphenofemoral junction may infrequently be altered in some individuals. Detailed preoperative sonographic examinations and meticulous groin dissection during the operation are necessary to prepare for unexpected anatomical variations.
Diagnosis ; Femoral Artery ; Femoral Vein ; Groin ; Humans ; Saphenous Vein ; Ultrasonography ; Varicose Veins* ; Veins

BACKGROUND: Conventional stripping is considered to be the standard procedure for great saphenous vein (GSV) varicosities, but many other alternative treatments such as cryostripping, endovenous laser therapy (EVLT), radio-frequency ablation, and ultrasound-guided foam sclerotherapy have been developed. Among them, both cryostripping and laser therapy have been reported to be less traumatic, with lower rates of complications and recurrences when compared to conventional stripping. To compare the efficacy of these treatments, we have analyzed and compared the mid-term clinical outcomes of cryostripping and EVLT. METHODS: Patients diagnosed with varicose veins of the GSV and treated with cryostripping or laser therapy between September 2008 and April 2013 were enrolled in this study. Duplex ultrasonography was used for the diagnosis and evaluation of varicosity and reflux, and the clinical-etiology-anatomy-pathophysiology classification was used to measure the clinical severity. The symptoms, Venous Clinical Severity Score (VCSS), recurrence rates, and complication rates of the cryostripping and laser therapy groups were analyzed and compared. RESULTS: A total of 68 patients were enrolled in this study. 32 patients were treated with cryostripping, and 36 patients were treated with laser therapy. The median follow-up period was 29.6 months. Recurrence was noted in three patients from the cryostripping group and in two patients from the EVLT group. There was no difference in the VCSS score, operative time, duration of hospital stay, and complication rate between the cryostripping group and the EVLT group. CONCLUSION: The mid-term clinical outcomes of cryostripping were not inferior to those of EVLT. Further, considering its cost-effectiveness, cryostripping seems to be a safe and feasible method for the treatment of varicose veins.
Classification ; Diagnosis ; Follow-Up Studies ; Humans ; Laser Therapy* ; Length of Stay ; Operative Time ; Recurrence ; Saphenous Vein ; Sclerotherapy ; Ultrasonography ; Varicose Veins*

Recent advances in radiological and serological techniques have enabled easier preoperative diagnosis of sparganosis. However, due to scarcity of cases, sparganosis has been often regarded as a disease of other etiologic origin unless the parasite is confirmed in the lesion. We experienced a case of sparganosis mimicking a varicose vein in terms of clinical manifestations and radiological findings. Sparganosis should be included among the list of differential diagnosis with the varicose vein.
Varicose Veins/*diagnosis/ultrasonography ; Thigh/*parasitology/pathology/surgery ; Sparganum/*isolation & purification ; Sparganosis/*diagnosis/pathology/surgery ; Magnetic Resonance Imaging/methods ; Knee/pathology/radiography ; Humans ; Female ; Diagnosis, Differential ; Animals ; Adult

BACKGROUND: Lower-limb varicose veins (VVs) are common and known to have a higher prevalence among people who work in occupations requiring prolonged standing. In the Republic of Korea, however, VV-related occupational factors have seldom been examined. This study was conducted to assess the prevalence of VVs among nurses, an occupational group considered to be at high risk of VVs, and determine the occupational risk factors of prolonged standing. METHODS: Between March and August 2014, a questionnaire survey coupled with Doppler ultrasonography was conducted on the nurses working at a university hospital. RESULTS: A total of 414 nurses participated in the survey and diagnostic testing. From the survey analysis and test results, the prevalence of VVs in nurses was estimated to be 16.18%. Significant factors for venous reflux were age [odds ratio (OR) = 1.06, 95% confidence interval (CI) = 1.03–1.10], pregnancy (OR = 2.15, 95% CI = 1.17–3.94), and delivery (OR = 2.02, 95% CI = 1.08–3.78). The statistical significance of these factors was verified after risk adjustment for sociodemographic factors (OR = 3.40, 95% CI = 1.27–9.09). CONCLUSION: Factors significantly associated with venous reflux were increasing age and prolonged working hours (≥ 4 hours) in a standing position (OR = 2.80, 95% CI = 1.08–7.25), even after risk adjustment for sociodemographic factors. This study is significant in that an objective diagnosis of VVs preceded the analysis of the risk factors for VV incidence, thus verifying objectively that VVs are associated with occupations requiring prolonged hours of working in a standing position.
Diagnosis ; Diagnostic Tests, Routine ; Humans ; Incidence ; Occupational Groups ; Occupations ; Posture ; Pregnancy ; Prevalence* ; Republic of Korea ; Risk Adjustment ; Risk Factors* ; Ultrasonography, Doppler ; Varicose Veins*

Cervical varix is a rare cause of obstetric hemorrhage which needs accurate diagnosis and prompt management because the lesion may be associated with preterm delivery and maternal complications. Our patient was diagnosed with cervical varix and vaginal bleeding at 32 weeks' gestation, using transvaginal ultrasound and MRI. Persistent vaginal bleeding and preterm labor led to an emergency cesarean section at 33 weeks'gestation. After delivery, cervical varix was spontaneously resolved in the follow-up transvaginal ultrasound and CT. We report various radiologic features of cervical varix combined with vaginal bleeding in late pregnancy.
Cervix Uteri ; Cesarean Section ; Diagnosis ; Emergencies ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Obstetric Labor, Premature ; Pregnancy* ; Ultrasonography ; Uterine Hemorrhage ; Varicose Veins*

Cervical varix is rare and can develop due to various conditions in pregnancy. Most cases of cervical varix during pregnancy are diagnosed in the second or third trimester and are usually associated with abnormal placental location, such as placenta previa or low-lying placenta. A 23-year-old woman with cervical varix bleeding visited our institution at 8 weeks of gestation. This case report describes cervical varix bleeding that developed into a venous thrombus in the first trimester. Ultrasonography with color Doppler and magnetic resonance imaging could be helpful in diagnosis.
Diagnosis ; Female ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Placenta ; Placenta Previa ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy Trimester, Third ; Pregnancy* ; Thrombosis* ; Ultrasonography ; Uterine Hemorrhage ; Varicose Veins* ; Young Adult

Varicose veins are dilated, tortuous veins exhibiting reflux because of valvular insufficiency. Dilatation of veins may be primary, that is, initiated by an unknown process, or may be the result of postthrombotic changes, arteriovenous fistula, or diverted flow resulting from a blockade of deep veins. Theoretical causes of varicose veins are heredity, race, gender, posture, gravitational back pressure, pregnancy, hormonal influence, weight, primary and secondary valvular incompetences, incompetent perforating veins, arteriovenous communications, and vein wall weakness. Visual inspection and palpation permit a clinical classification with respect to many different factors, especially the type of varix and the clinical stage of chronic venous insufficiency. Refluxes play a decisive role in the pathogenesis of large varices. They are usually detected over the sapheno femoral junction or the saphenopopliteal junction. Identification of these refluxes needs Doppler ultrasonographic techniques. Highly effective noninvasive examination methods have become available and include photoplethysmography, air plethysmography, portable Doppler ultrasound, and duplex scanning. The sole invasive diagnostic technique is ascending or descending phlebography. Several different treatments have been recommended for varicose veins. Flush ligation combined with stripping, avulsion of local varicosities, and perforator interruption are still the most common surgical techniques. The aim of varicose vein surgery is the removal of diseased incompetent vein segment and the control of reflux. Development of new sclerosing agents renders sclerotherapy for varicose veins more effective, and use of Doppler and the duplex ultrasound techniques provides a better hemodynamic and anatomic precision, which ultimately improves the treatment efficacy. Because patients seek treatment for varicose veins most commonly for cosmetic reasons, recently developed lasers and intense pulsed light(IPL) have become the methods for treating telangiectasia. In summary, surgery treats the major venous reflux, sclerotherapy treats the feeding venous system, and the laser or IPL seals effectively the superficial vessels.
Arteriovenous Fistula ; Classification ; Continental Population Groups ; Diagnosis* ; Dilatation ; Hemodynamics ; Heredity ; Humans ; Ligation ; Palpation ; Phlebography ; Photoplethysmography ; Plethysmography ; Posture ; Pregnancy ; Sclerosing Solutions ; Sclerotherapy ; Telangiectasis ; Treatment Outcome ; Ultrasonography ; Varicose Veins* ; Veins ; Venous Insufficiency

The tarsal tunnel is located beneath the flexor retinaculum, which connects the medial malleolus and calacaneus. The tarsal tunnel contains the posterior tibialis tendon, flexor digitorum longus tendon, posterior tibial artery and vein, posterior tibial nerve, and flexor halluces longus tendon. Tarsal tunnel syndrome is a compressive neuropathy of posterior tibial nerve and its branches under the flexor retinaculum. The etiologies of tarsal tunnel syndrome are space-occupying lesion, hypertrophied flexor retinaculum, osteophytes, tarsal coalition, varicose vein, and trauma. The symptoms are foot pain and hypoesthesia or paresthesia at dermatome according to involving nerve branches. Clinical diagnosis can be obtained from a detailed history and physical examination such as compressive test at the tarsal tunnel area. Ultrasonography and magnetic resonance imaging can reveal the space-occupying lesion, such as ganglion, lipoma, and neuroma. The initial treatments of tarsal tunnel syndrome are conservative management, such as physical therapy, night splint, and steroid injection. Surgical decompression is indicated after failure of conservative managements. Variable results of surgical treatment have been reported. Favorable result after decompression could be obtained from young patients, early onset symptoms, and space-occupying lesion.
Decompression ; Decompression, Surgical ; Diagnosis ; Foot ; Ganglion Cysts ; Humans ; Hypesthesia ; Lipoma ; Magnetic Resonance Imaging ; Neuroma ; Osteophyte ; Paresthesia ; Physical Examination ; Splints ; Tarsal Tunnel Syndrome* ; Tendons ; Tibial Arteries ; Tibial Nerve ; Ultrasonography ; Varicose Veins ; Veins

OBJECTIVE: This study reviewed clinical characteristics of fetal intra-abdominal umbilical vein (FIUV) varices that were detected during antenatal ultrasound examinations. METHODS: Between January 2006 and January 2012, 121 cases of FIUV varices were detected and 7 cases were lost to follow-up. We retrospectively reviewed the medical records of 114 patients and neonates. RESULTS: From a total 96,553 ultrasound examinations in 43,995 pregnancies, 121 cases of FIUV varices were identified (2.8 per 1,000 pregnancies). Gestational age at diagnosis was 32.0 +/- 2.9 weeks (range, 20.1-36.3 weeks), the mean diameter of the FIUV varix was 12.6 +/- 2.1 mm (range, 8.0-21.0 mm) at initial diagnosis and the mean maximal diameter was 13.1 +/- 2.3 mm (range, 8.0-21.0 mm) during follow-up. The most severe pregnancy complications included one case of intrauterine fetal death and another case of fetal hydrops. Associated fetal anomalies (n = 11, 9.6%) detected by ultrasonography included bilateral renal pelvis dilatation, ventriculomegaly, cryptorchidism, incomplete renal duplication and pulmonary sequestration. A total of 104 cases (91.2%) were delivered at term and 10 cases (8.8%) were preterm deliveries before 37 weeks of gestation. CONCLUSION: FIUV varices that are not associated with fetal anomalies based on ultrasound examination during prenatal care have favorable pregnancy outcomes. Nevertheless, close fetal monitoring is recommended to decrease perinatal complications.
Bronchopulmonary Sequestration ; Cryptorchidism ; Diagnosis ; Dilatation ; Female ; Fetal Death ; Fetal Monitoring ; Follow-Up Studies ; Gestational Age ; Humans ; Hydrops Fetalis ; Infant, Newborn ; Kidney Pelvis ; Lost to Follow-Up ; Male ; Medical Records ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Prenatal Care ; Retrospective Studies ; Ultrasonography ; Umbilical Veins* ; Varicose Veins*