1/12. A clinical report about an unusual occurrence of post-anesthetic tongue swelling.dentures are routinely removed from the oral cavity before general anesthetic procedures. They are only reinserted much later when the patient returns to the room. This clinical report describes an edentulous patient who developed acute tongue swelling from venous congestion as a result of tongue recovery from general anesthesia. Her complete dentures were used to separate the residual ridges during the recovery period and relieved the congestion. Denture insertion increased the height and volume of the oral cavity, which reduced pressure on the tongue, preventing a cycle of tongue compression, congestion, and swelling. This unusual complication suggests that it may be prudent for the edentulous patient to be accompanied by their dentures in the perioperative period.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/12. A new autologous venous valve by intimal flap. One case report.Various surgical techniques have been proposed for the treatment of chronic venous insufficiency of post-thrombotic recanalized deep veins of the lower limbs. The preferable method seems to be represented by intravenous valvuloplasty except for the cases affected by extensive valvular damage. For this reason some experimental autologous, heterologous and prosthetic venous valves have been proposed. Such a problem emerged for 1 patient (male, aged 78 years, right limb, leg dystrophy, multiple ulcerations at the ankle) which was selected by duplex, Doppler venous pressure index, photoplethysmography and ascending phlebography. An iliac-femoral and popliteal post-thrombotic, recanalized, decompensated venous insufficiency and one Cockett's perforator incompetence were diagnosed (CEAP classification: C6s Es As2d14 Pr). A bicuspid apparently repairable popliteal valve was detected by phlebography. A traditional intravenous valvuloplasty was planned but the valve was not found at surgical exploration. A monocuspid valve reconstruction by intimal flap vein was performed. The following results were obtained and controlled after one year: stable ulceration healing, dystrophy reduction, improvement in the quality of life, normalization of the hemodynamic parameters and of the radiological morphology of the new valve. It can be concluded that monocuspid valvular repair by intimal flap can be successfully performed in cases affected by secondary valveless deep venous insufficiency of the lower limbs.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/12. Hemosiderotic fibrohistiocytic lipomatous lesion: clinical correlation with venous stasis.Hemosiderotic fibrohistiocytic lipomatous lesion (HFLL) is a recently proposed lipomatous entity. HFLL was originally suggested to be a benign reactive lesion arising due to an antecedent trauma. We report two patients with HFLL who also suffered from chronic vein insufficiency due to varicose involving deep veins of the low limbs. Both patients were middle-aged women with solitary, poorly circumscribed subcutaneous lesions on the lower extremities. Histopathological examination revealed typical features of HFLL. We think that the consistent clinical features such as advanced age, female sex predilection, and specific location along with distinctive histopathological features allow the suggestion that impaired blood circulation, to wit, venous stasis is involved in the pathogenesis of HFLL. We hypothesize that the proliferation of spindled fibroblastic and myofibroblastic cells and capillaries, erythrocyte extravasation, and hemosiderin deposition with lipomatous tissue of HFLL may simply represent an exaggerated tissue response to venous stasis in which elevated venous and capillary pressures, oxygen saturation, and edema stimulate the proliferation of the above mentioned elements and lead to erythrocyte extravasation. A similar histopathological pattern is seen in acroangiodermatitis of mali and vascular transformation of lymph node sinuses, and these conditions are also associated with impaired blood circulation.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/12. venous insufficiency in a young man secondary to a traumatic arteriovenous fistula.The medical history in a young man who developed varicose veins and venous insufficiency secondary to an acquired arteriovenous fistula in the thigh is presented. The radiological and clinical findings are discussed. The disease process in the development of varicose veins is not fully understood and cannot be satisfactorily explained as a consequence of arterial pressure within the venous system or a defect in the venous valves alone. The widespread ectatic changes seen within the venous system in our patient suggests the activation of an unknown, possibly humoral factor, resulting in morphological modifications in the vein wall.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/12. Transluminal angioplasty of a stenotic surgical splenorenal shunt.A stenosis of a side-to-side splenorenal shunt was treated by percutaneous angioplasty two years after the performance of the shunt. After dilatation, there was a fall of the splenorenal pressure gradient from 28 to 17 cm H2O and good transanastomotic flow was re-established. As in other arterial and venous territories, angioplasty may be an interesting alternative to surgery.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/12. Decreased venous outflow without venous obstruction--an analysis of three cases.Three patients without prior thrombosis or varicosities presented with decreased venous outflow. They suffered from venous complaints, such as oedema and pain in the leg after prolonged standing. Phlebograms showed no obstruction or hypoplasia. Normal function of calf muscle pump and valves was present at venous pressure determination. The theoretical basis of venous emptying is discussed and a hypothesis is postulated that decreased emptying is due to a change in elastic properties of the venous vessel wall.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/12. Errors in the differential diagnosis of incompetence of the popliteal vein and short saphenous vein by Doppler ultrasound.Doppler Ultrasound is now routinely used to demonstrate valvular reflux in the venous system. Incompetence detected at the back of the knee is located either in the short saphenous vein or in the popliteal vein. Whether the incompetence is in the deep or superficial venous system can be differentiated by digital compression over the short saphenous vein in the upper calf; if reflux is abolished then the incompetence is assumed to be in the superficial vein but if it is not prevented it must be in the popliteal vein. Sometimes the reflux is not controlled when the deep system is normal. This has been shown to be due to variations in the anatomy of the short saphenous vein and especially the pattern of its termination. Examples with venography are given, showing that in the presence of incompetence at the sapheno-popliteal junction there may be no reflux in the short saphenous vein; instead the proximal tributaries are involved and reflux in these veins is not controlled by pressure over the short saphenous vein. This explains the false positive diagnosis of valvular incompetence in the popliteal vein.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/12. Superficial posterior compartment syndrome of the leg with deep venous compromise. A case report.A 15-year-old boy was struck twice in the calf, developing what appeared initially to be phlebitis and deep venous compromise. Careful clinical examination and compartment pressure measurement revealed the presence of an isolated superficial posterior compartment syndrome. Fasciotomy provided prompt relief. Findings at surgery showed ischemic changes but no necrosis. Venous patency was demonstrated on a subsequent venogram. Recovery was complete. This is the first reported case of isolated traumatic superficial posterior compartment syndrome. It adds to numerous other reports and provides further evidence that compartment syndrome can occur in any myofascial compartment. The concurrent deep venous compromise, although physiologically expected because of pressure differentials, was graphically demonstrated for the first time as well. Its clinical significance is not clear.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
9/12. Compression of superior vena cava associated with aneurysmal dilatation of left atrium.A patient with rheumatic mitral valve disease and persistently elevated jugular venous pressure (JVP) is described. angiography revealed a valve-like structure in the superior vena cava (SVC) at the site where a pressure gradient was recorded. At operation, this previously unreported anomaly proved to have been caused by aneurysmal dilatation of the left atrium which exerted traction on the pericardial insertion to the SVC. Disinsertion of the pericardial attachment to the vena cava at the time of mitral valve replacement released the compression. Postoperatively, the JVP became normal.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
10/12. The iliac compression syndrome.The iliac compression syndrome is caused by impaired venous drainage of the left leg, secondary to compression or stricture of the left iliac vein at, or just before, its junction with inferior vena cava. Serious potential complications are deep vein thrombosis, pulmonary embolism, venous congestion, and the resultant incapacity. Nine patients in whom the diagnosis was confirmed by iliac phlebography are described. Iliac pressure determinations were made in 7 patients. Four patinets underwent resection, and retroplacement of the right iliac artery behind the left iliac vein. The operative results were good. This rare syndrome should always be considered in the differential diagnosis of peripheral venous disease, as it can be treated in the early stages. If it is left untreated, there is a risk of pulmonary embolism or incapacitating peripheral vascular disease.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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