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Abstract: The patient presented to the hospital with a 10-year history of earthworm-like tortuous mass in the left lower extremity with localized pain. After physical examination and ultrasound, the patient was diagnosed with left lower extremity saphenous varicose vein and was admitted to the hospital for treatment. The patient was discharged from the hospital in 1 day after minimally invasive surgical treatment, and the results of the follow-up examination showed that the varicose vein mass had healed well after surgery and disappeared completely.
Basic information】Female, 60 years old
Disease Type】Left lower extremity saphenous varicose vein
Hospital】Tianjin Fourth Central Hospital
Consultation time】May 2022
Treatment plan】Minimally invasive surgical treatment (saphenous vein trunk stripping, sclerotherapy injection of veins belonging to the saphenous vein)
Treatment period】1 day hospitalization, 1 week postoperative outpatient medication change, 1 month postoperative review
Treatment effect] The varicose vein mass disappeared completely and healed well
I. Initial consultation
The patient came to our hospital because of a 10-year old earthworm-shaped tortuous mass in the left lower extremity with localized pain. On examination after admission, it was seen that the patient had dilated and tortuous veins in the left lower extremity in the saphenous vein travel area, which protruded from the skin surface, with no localized skin redness or swelling and no skin tenderness. The patient’s venous mass was soft in texture, the saphenous vein function test and valve function test were negative, and the coagulation function was normal. Later, ultrasound examination was performed, suggesting that the patient’s left lower extremity deep veins were patent and there was no cardiac malformation, and the patient was diagnosed as left lower extremity saphenous varicose vein.
II. Treatment process
After consultation with the patient, it was decided to perform saphenous vein trunk stripping, together with sclerotherapy of the veins belonging to the saphenous vein. After marking the veins of the lower extremity, a vein stripping catheter was placed in the trunk of the saphenous vein under anesthesia, and then foam sclerosing agent was injected into the vessels of the branches of the vein. The incision was closed by intracutaneous suture, and the operation was carried out smoothly.
III. Treatment results
The patient was treated by minimally invasive stripping and sclerotherapy with no intraoperative discomfort and a good postoperative recovery, which hardly affected normal walking. The patient was successfully discharged from the hospital 1 day after the surgery. 1 week after the surgery, the patient went to the outpatient clinic for a follow-up examination and indicated that he had no discomfort in his life. One month after the surgery, the patient came back for a follow-up examination and the varicose vein mass had completely disappeared and was healing well.
IV. Notes
We are glad that the varicose vein mass disappeared completely after treatment, but since varicose veins often recur, patients still need to pay attention to the following points after discharge.
1, patients do not have to be absolutely bed rest after discharge, they can get out of bed appropriately, which can effectively avoid deep vein thrombosis, but they should avoid standing and sitting for a long time.
2, patients can properly exercise calf muscles, or daily wear varicose veins elastic stockings, can be worn during the day and taken off at night. In addition, if the leg appears swollen, the limb can be elevated.
3, daily should pay attention to diet, mainly light and easy to digest diet, avoid spicy and stimulating food, in order to promote the recovery of the body.
4. Patients should go to the outpatient clinic for medication change 1 week after surgery, and go to the outpatient clinic for review 1 month after surgery, and should also review the lower limb vascular ultrasound regularly.
V. Personal insight
Varicose veins are a common clinical disease, the main cause of which is the stagnation of blood in the veins due to the weakness of the vein wall and the incompetence of the venous valves, which leads to the increase of the venous pressure and then causes the dilatation and tortuosity of the veins. Patients often experience dilated and tortuous veins in the saphenous area of the legs, which protrude from the skin like earthworms. Patients often feel heavy and swollen in the lower limbs, and may also experience eczema and itching of the skin, or even superficial venous thrombosis and skin breakdown and bleeding. The varicose veins can be treated by traditional surgery or minimally invasive surgery, and the current clinical application is minimally invasive surgery.