Diseases of Veins-Phlebitis
Definition
It is a
condition characterized by inflammation of the veins.
Etiology
1.Age:any.
2.Sex
:male=female.
3.Site:usually
veins of the lower limbs.
4.Chronic
or prolonged illness, e.g. typhoid.
5.Intravenous
injection or irritant solutions.
6.Surgical
injury to the vein.
7.Puerperium.
Clinical features
1.The
part around a superficial vein is swollen.
2.There
is pain over the affected vein.
3.There
is swelling over the lower leg if the deep vein is thrombosed.
4.
A clot may get dislodged from a deep
vein and embolize to the lungs.
Venous Thrombosis
1.Chronically
bedridden patient.
2.Prolonged
bed rest post operatively.
3.Combination
contraceptive pills.
4.Pregnancy.
5.Puerperium.
6.Congestive
cardiac failure.
Clinical features
2.Oedema
of feet and lower legs.
3.Pain
in the lower limbs.
4.Calf
tenderness.
5.Low
grade fever.
6.Calf
pain on forced dorsiflexion of the foot.
Treatment
1.Elastic
bandage to the lower limb.
2.Bed
rest with splints or sand bag support to the lower limbs to prevent pulmonary
embolism.
3.Anticoagulant
therapy with heparin, followed by warfarin later.
Prevention
1.Avoid
prolonged bed rest.
2.Leg
exercise in high risk cases.
3.Low-dose
heparinization in high risk cases.
4.Deep
breathing exercise.
Varicose Veins
Definition
It is a condition characterized by elongation and expansion of the superficial veins, so that they are tortuous and distended.
Aetiology
1.Congenital
weakness or defect in valves in veins.
2.
Heredity.
3.Increase
in the intra abdominal pressure due to a tumor.
4.Pregnancy.
5.Deep
vein thrombosis.
6.Prolonged
standing.
Clinical features
1.MIild
cases are asymptomatic.
2.The
lower limb is disfigured, which the patient may find disturbing cosmetically.
3.Pain in
the calf.
4.Varicose
ulcer :Chronic in nature, located over the medial malleolus.
5.Dilate
and tortuous veins in the lower limbs.
6.Venous
blow-outs over the site of the incompetent valves.
7.Oedema
feet.
Treatment
|
Stage |
Treatment |
|
Early |
.
Elastocrepe
bandage. .Leg exercise. .Avoidance of
trauma. |
|
Pregnancy |
.As above. .Ligation of the
incompetent valves surgically. .Removal of the
varicose veins by stripping. |
|
Patient unfit for
surgery in case of advanced varicose veins. |
Injection of
sclerosants in the veins to occlude them. |
Complications
1.Phlebitis
2.Deep
vein thrombosis.
3.Varicose
ulcer.
4.Haemorrhage
from trauma to the vessels.
5.Talipes
equines.
Prevention of complications
1.Avoid
prolonged standing.
2.Use of
shoes instead of slippers or chappals.
3.Avoid
sitting cross-legged.
4.Leg
exercises.
5.Ambulation.
6.Bath
at night.
7.Elevation
of the foot end of the bed while sleeping.
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