1/52. Leg ulcers: a common problem with sometimes uncommon etiologies.In the U.S., leg ulcers present a significant clinical problem, occurring at a rate of approximately 600,000 new cases per year. In most cases, the cause of ulceration is venous or arterial in nature. One uncommon but significant cause of leg ulcers is sqaumous cell carcinoma (SCC). Although the incidence of SCC is higher in white than black populations, blacks with SCC typically exhibit involvement of areas of the skin that are not chronically sun-exposed, especially the lower extremeties. Predisposing factors include burn scars, chronic infection or ulceration, and chronic discoid lupus erythematosus. Leg ulcers of atypical presentation or those that fail to heal should alert the clinician to consider uncommon etiologies.- - - - - - - - - - ranking = 1keywords = leg ulcer, ulcer, leg (Clic here for more details about this article) |
2/52. Temporary arterio-venous shunts to dilate saphenous crossover graft and maintain graft patency.A modification of the Palma operation is described in a 25-year-old man with impaired venous outflow of the right leg. After a phlebitic occlusion of the right superficial femoral and external iliac veins he had been operated on twice for varicose veins. The result of these operations was a serious outflow stasis of the right leg during exercise. A saphenous cross-over graft to the right popliteal vein was constructed. Preoperatively a temporary arterio-venous shunt between the left posterior tibial artery and the great saphenous vein had been made in order to increase the diameter of the saphenous vein. Three months later the dilated saphenous vein was resected at the level of the sapheno-tibial artery shunt and anastomosed to the popliteal vein of the right leg. The cross-over graft occluded several times during this operation. A temporary popliteo-popliteal arterio-venous shunt was established distally to the sapheno-popliteal anastomosis to keep the vein graft patent. This second arterio-venous shunt was resected after three months. Venography one month later showed that the vein graft was patent. The patient's complaints had disappeared one month after the operation and a normalization of his venous outflow was recorded plethysmographically. The graft has remained patent during an observation time of eighteen months.- - - - - - - - - - ranking = 0.0074064807018337keywords = leg (Clic here for more details about this article) |
3/52. Lipodermatosclerosis - report of three cases and review of the literature.We report 3 cases of lipodermatosclerosis (LDS) and discuss the nosology of similar disorders caused by venous insufficiency of the legs. These cases are characterized by (1) occurrence in middle-aged or aged woman, (2) painful, indurated erythema with hyperpigmented scleroderma-like hardening on the lower leg, (3) lobular panniculitis with membranocystic fat necrosis and various degrees of septal fibrosis. Although the designation LDS has been used particularly in the UK and in the USA, this entity is not familiar in other countries including japan. LDS clinically represents a wide spectrum from an acute, inflammatory phase to a chronic, fibrotic state. The clinicopathologic findings of LDS are similar or identical to the disease previously reported as chronic indurated cellulitis, hypodermitis sclerodermiformis, stasis panniculitis or sclerosing panniculitis. These diseases are probably related conditions, which depend upon the various stages.- - - - - - - - - - ranking = 0.0049376538012225keywords = leg (Clic here for more details about this article) |
4/52. Chronic leg ulcers: types and treatment.Disorders of the arteries, veins, or nerves, alone or in combination, can result in leg ulcers. The presentation in these cases varies with the cause, which in turn guides management. A differential diagnosis is critical, because treatment that is essential for one type of ulcer may be contraindicated in another.- - - - - - - - - - ranking = 2.4083448013148keywords = leg ulcer, ulcer, leg (Clic here for more details about this article) |
5/52. Recurrent varicose veins of both lower limbs due to bilateral ovarian vein incompetence.A case of a 43-year-old female patient with mild pelvic pain and bilateral recurrent varicose veins due to incompetence of both ovarian veins is presented here. Ovarian vein incompetence was suspected from the presence of vulva varicosities and was confirmed by transvaginal ultrasound and descending ovarian venography. Treatment with transcatheter embolization of the ovarian veins was followed by local excision of the leg varices. Four years later, the patient remains asymptomatic and without any recurrence of varicose veins in both lower limbs.- - - - - - - - - - ranking = 0.0024688269006112keywords = leg (Clic here for more details about this article) |
6/52. Fluctuating monoplegia due to venous insufficiency by spinal arachnoiditis ossificans.This is the first report of a patient with venous insufficiency following compressive arachnoiditis ossificans (AO). Symptoms of fluctuating monoplegia and sensory disturbance appeared monthly, lasting several weeks each time. Spinal magnetic resonance imaging (MRI) showed high T2-weighted signal intensity in the posterior portion of the column from T11 to T12 and an intradural lesion with low T2-weighted signal intensity. Neurological function and MRI improved markedly following an operation on AO. The symptoms seen in the present case were due to posterior venous insufficiency following compressive AO.- - - - - - - - - - ranking = 0.012344134503056keywords = leg (Clic here for more details about this article) |
7/52. Multiple pseudolymphomas caused by hirudo medicinalis therapy.Therapy with medicinal leeches (hirudo medicinalis) is now frequently applied in plastic surgery and in the management of chronic venous insufficiency. We observed a patient in whom firm, brown-red, pea-sized papules developed at each site where leeches had been applied on the lower legs. histology, immunohistology, and molecular analysis of T-cell receptor and immunoglobulin heavy chain gene rearrangement proved these lesions to be follicular pseudolymphomas.- - - - - - - - - - ranking = 0.0024688269006112keywords = leg (Clic here for more details about this article) |
8/52. Compression of femoral vein by the strap of a urine-collecting device in a spinal cord injury patient.OBJECTIVE: To report an unusual cause of femoral vein compression in a spinal cord injury (SCI) patient. DESIGN: A case report of a SCI patient in whom the strap of a urinal produced compression of femoral vein. Setting Regional spinal injuries Centre, Southport, england. SUBJECT: A 65-year old male, who had sustained paraplegia at T-10 level 33 years ago, attended the spinal unit for a routine follow-up intravenous urography (IVU). He was wearing a urinal, which was held tightly over the penis by means of two straps coursing over the inguinal regions. MAIN OUTCOME MEASURES: IVU was performed by injecting 50 ml of Ultravist-300 via a 23-gauge butterfly needle inserted in a vein over the dorsum of the left foot. After completion of the injection, an X-ray of the pelvis was taken to evaluate the right hip. This showed contrast in the vena profunda femoris, circumflex femoral veins and inter-muscular veins with evidence of compression of proximal femoral vein. RESULTS: It was suspected that the strap holding the urinal was causing compression of the femoral vein. Therefore, a venogram was performed 5 days later, when the patient had discarded the urinal and the straps. This showed free flow of contrast through the left femoral and iliac veins. CONCLUSION: Compression of femoral vein by a strap holding the urinal was discovered serendipitously in this patient during a routine follow-up. physicians and health professionals should bear in mind this rare complication when examining spinal cord injury patients who use this type of urine collecting device, and discuss with them alternative methods for urinary drainage.- - - - - - - - - - ranking = 0.0024688269006112keywords = leg (Clic here for more details about this article) |
9/52. Persistent leg ulcers in an obese patient with venous insufficiency and elephantiasis.Options in Practice presents different management approaches to the same clinical situation. You are invited to submit a brief case description, including the specialty nursing care provided, and several glossy color photographs of the clinical situation. The case material will then be sent to another wound, ostomy, or continence care nurse, who will also address management concerns. Alternative solutions to difficult wound, ostomy, or incontinence clinical situations will be published.- - - - - - - - - - ranking = 1.9222319526307keywords = leg ulcer, ulcer, leg (Clic here for more details about this article) |
10/52. Congestive heart failure associated with chronic venous insufficiency and leg ulcers secondary to an arteriovenous fistula caused by a shotgun wound 15 years ago.We present a 65-year-old man who had a significant arteriovenous fistula between the right arteria profunda femoralis and vena profunda femoralis. He had evidence of chronic venous insufficiency and chronic leg ulcers on his right leg, and he had clinical findings of congestive heart failure. An arteriovenous fistula was responsible for all of clinical situation that had been caused by a shotgun wound 15 years ago. Using ultrasonography, after palpating a marked thrill and mass during physical examination, established the diagnosis of arteriovenous fistula. angiography was performed both to delineate the suspected vascular anatomy and to show the coronary arteries. The patient was operated on and no complication was experienced during or after the procedure. Dramatic improvement was seen in the clinical picture just after surgery, and heart size markedly reduced both on chest X-ray and echocardiographic examination.- - - - - - - - - - ranking = 2.405258767689keywords = leg ulcer, ulcer, leg (Clic here for more details about this article) |
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