Chronic Venous Disease

Inspection with the patient standing is one of the most important aspects of the examination of chronic venous disease. The dilated veins of superficial disease are frequently obvious. Other signs of importance include swelling, hemosiderosis of the skin of the malleolar area, lipodermatosclerosis, atrophie blanche, and ulceration (Fig. 2.10). Deep venous disease may be less obvious and present simply with chronic swelling of the limb. In later stages, all of the above signs may be present.

Figure 2.10. Chronic venous insufficiency. The limbs demonstrate the brownish discoloration associated with lipatoder-matosclerosis.Varicosities are also present.

Figure 2.9. Gangrene from drug injection. Injection into the radial artery led to gangrene to the thumb and thenar eminence.

Figure 2.10. Chronic venous insufficiency. The limbs demonstrate the brownish discoloration associated with lipatoder-matosclerosis.Varicosities are also present.

VASCULAR SURGERY

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