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Abstract: This article describes a middle-aged female patient with 8 years of right superficial calf vein manifestation, aggravated for 2 years, accompanied by soreness and weakness in the lower limbs. After admission to the hospital, relevant tests were completed and ultrasound suggested small saphenous varicose vein. The patient was recommended to undergo surgical treatment, and the procedure used was high ligation of the small saphenous vein with dot stripping. One month after the operation, the varicose vein disappeared, and the soreness and swelling of the lower limbs were significantly relieved to disappear.
Basic information】Female, 52 years old
Disease Type】Small saphenous varicose vein
Hospital】Liaoning Provincial People’s Hospital
Date of Consultation】March 2022
Treatment plan】High ligation of small saphenous vein with dot stripping, postoperative compression with medical compression stockings
【Treatment Period】Inpatient treatment for 2 days, return to outpatient clinic for review in 1 month
Results】The varicose vein disappeared, and the patient’s lower limb pain and swelling disappeared.
I. Initial consultation
Ms. Xu, 52, came to the department with “superficial vein of right lower extremity exposed for 8 years, aggravated for 2 years”. The patient had lower extremity vein exposed 8 years ago with no obvious cause, confined to the back of the lower leg. Initially, there were no symptoms, but 2 years ago, the veins of the lower extremities became obvious protruding, and the soreness and weakness of the lower extremities appeared after sitting and standing for a long time, which could be relieved by elevating the affected extremities, without obvious complications such as pigmentation, itching, desquamation and skin breakdown. The patient was physically fit in the past and had no other diseases. On examination, tortuous veins were seen in the right lower extremity, confined to the posterior side of the calf, with local swelling, normal arterial pulsation and normal sensorimotor function. Considering that the patient’s varicose veins were mainly confined to the posterior side of the calf, ultrasound of saphenous vein and small saphenous vein was performed, suggesting small saphenous varicose veins.
II. Treatment history
The patient had symptoms of venous insufficiency and no skin pigmentation and other dermatitis changes, so it was the best time for surgery. After communicating with the patient and his family, we decided to perform the surgery. The preoperative preparation was improved, and the biochemical examination results were not significantly abnormal. After explaining the patient’s condition to the patient and family, a high ligation of the small saphenous vein with dot stripping was performed under local anesthesia. During the operation, ultrasound was used to localize the patient’s varicose veins, and the cause of the varicose veins was once again clarified as small saphenous vein reflux. The patient was discharged from the hospital after 2 days of hospitalization because the elastic bandage was removed and the medical compression stocking was replaced after 1 day.
III. Treatment effect
At the time of the first visit, the patient’s posterior calf vein was exposed, accompanied by soreness and weakness of the lower limbs. After the surgical treatment, the exposed tortuous vein mass disappeared and the incision was well healed at the time of dressing change, and the patient’s soreness and swelling in the lower limbs were significantly relieved. The patient was asked to return to the outpatient clinic 1 month after the surgery for a review, and then the incision was completely healed, and the patient’s soreness and weakness in the legs after sitting and standing for a long time disappeared significantly, and there was no recurrence of varicose veins.
IV. Precautions
After the surgical treatment, the patient’s discomfort obviously subsided and the quality of life improved, so as a doctor, we are truly happy for the patient. However, patients should pay attention to personal hygiene and cleanliness after discharge from the hospital to ensure that the surgical incision is dry and hygienic so as not to cause infection. Within 1 month after surgery, patients should avoid heavy physical labor and try not to sit for a long time. It is possible to wear compression stockings for a long time, and the general wearing time is better than 3-6 months to avoid the recurrence of small saphenous varicose veins.
V. Personal insight
Saphenous varicose vein may be related to heavy physical labor and prolonged standing, so you should try to avoid such situation in your daily life. If you are diagnosed with saphenous varicose vein, you should not worry too much, but you should not ignore it. It is recommended to visit a professional hospital and choose the right treatment method to improve your condition with the help of your doctor. For the doctor, when viewing the patient’s condition, in addition to clarifying the specific symptoms, test reports and other materials, he or she should also understand the patient’s daily life status, which can help to comprehensively analyze and judge the causative factors of the disease.