Pelvic vein reflux in female patients with varicose veins: comparison of incidence between a specialist private vein clinic and the vascular department of a National Health Service district general hospital

2009 ◽  
Vol 24 (3) ◽  
pp. 108-113 ◽  
Author(s):  
P Marsh ◽  
J Holdstock ◽  
C Harrison ◽  
C Smith ◽  
B A Price ◽  
...  
Keyword(s):  
General Hospital ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
District General Hospital ◽  
Hospital Unit ◽  
Female Patients ◽  
Pelvic Vein ◽  
One Year ◽  
Unit Unit ◽  
Vein Reflux

Objectives Mounting evidence suggests that pelvic vein reflux is an important contributing factor to recurrent varicose veins. We compared the incidence in our specialist private unit (Unit A) with that of a District General Hospital (Unit B). Methods Results of all female patient lower limb duplex ultrasound (LLDUS) and transvaginal pelvic ultrasound (TVUS) scans performed over a one-year period were retrospectively reviewed. Patients with refluxing veins emanating from the abdomen or pelvis on LLDUS (non-saphenous reflux) routinely proceeded to TVUS in Unit A. Results In Unit A, non-saphenous reflux on LLDUS was present in 90–462 female patients (19.5%). In 81.1% of these, TVUS confirmed reflux in truncal pelvic veins (incidence 15.8%). In Unit B, non-saphenous reflux was present in 60–279 female patients (21.5%). Conclusion One in five women presenting with varicose veins have reflux of non-saphenous origin. This is the case in specialist and non-specialist units. One in six has associated pelvic vein reflux.

Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux

2014 ◽  
Vol 30 (2) ◽  
pp. 133-139 ◽  
Author(s):  
JM Holdstock ◽  
SJ Dos Santos ◽  
CC Harrison ◽  
BA Price ◽  
MS Whiteley
Keyword(s):  
Varicose Veins ◽  
Strong Association ◽  
Duplex Ultrasound ◽  
Iliac Vein ◽  
Venous Reflux ◽  
Foam Sclerotherapy ◽  
Pelvic Vein ◽  
Internal Iliac Vein ◽  
Internal Iliac ◽  
Vein Reflux

Objectives: To determine the prevalence of haemorrhoids in women with pelvic vein reflux, identify which pelvic veins are associated with haemorrhoids and assess if extent of pelvic vein reflux influences the prevalence of haemorrhoids. Methods: Females presenting with leg varicose veins undergo duplex ultrasonography to assess all sources of venous reflux. Those with significant reflux arising from the pelvis are offered transvaginal duplex ultrasound (TVS) to evaluate reflux in the ovarian veins and internal Iliac veins and associated pelvic varices in the adnexa, vulvar/labial veins and haemorrhoids. Patterns and severity of reflux were evaluated. Results: Between January 2010 and December 2012, 419 female patients with leg or vulvar varicose vein patterns arising from the pelvis underwent TVS. Haemorrhoids were identified on TVS via direct tributaries from the internal Iliac veins in 152/419 patients (36.3%) and absent in 267/419 (63.7%). The prevalence of the condition increased with the number of pelvic trunks involved. Conclusion: There is a strong association between haemorrhoids and internal Iliac vein reflux. Untreated reflux may be a cause of subsequent symptomatic haemorrhoids. Treatment with methods proven to work in conditions caused by pelvic vein incompetence, such as pelvic vein embolisation and foam sclerotherapy, could be considered.

scholarly journals Erratum

1996 ◽  
Vol 116 (3) ◽  
pp. 383-383
Keyword(s):  
General Hospital ◽  
Broad Spectrum ◽  
Varicose Veins ◽  
District General Hospital ◽  
Operating Theatre ◽  
Necrotising Fasciitis ◽  
Tissue Sections ◽  
Intravenous Antibiotics ◽  
Epidemiol Infect ◽  
Gram Positive Cocci

Epidemiol. Infect. 115 (1995), 387–97K.Cartwright, M.Logan, C.McNulty, S.Harrison, R. George, A.Efstratiou, M.McEvoy and N.BeggA cluster of cases of streptococcal necrotising fasciitis in GloucestershirePage 389,final paragraph should read:Patient BThree days later (7 February), patient B underwent a routine sapheno-femoral disconnection for varicose veins in the same operating theatre. In the evening she developed diarrhoea which persisted overnight; gastroenteritis was suspected. Early the next morning she was re-examined by her surgeon and was transferred to the district general hospital at about midday. NF was suspected, broad-spectrum intravenous antibiotics were commenced and surgery arranged. The diagnosis was confirmed at operation. The affected tissues were excised and specimens sent for culture and histology. Chains of Gram-positive cocci were seen in tissue sections and later, S. pyogenes was isolated.

One-year outcomes of radiofrequency ablation of incompetent perforator veins using the radiofrequency stylet device

2010 ◽  
Vol 25 (2) ◽  
pp. 79-84 ◽  
Author(s):  
P Marsh ◽  
B A Price ◽  
J M Holdstock ◽  
M S Whiteley
Keyword(s):  
Radiofrequency Ablation ◽  
De Novo ◽  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Clinical Score ◽  
Clinical Series ◽  
Specific Device ◽  
Primary Varicose Veins ◽  
One Year

Objectives Early success treating incompetent perforator veins (IPVs) with radiofrequency ablation (RFA) and the trend to move varicose vein surgery into a walk-in walk-out service led to the design of a specific device enabling RFA of IPVs using local anaesthesia (ClosureRFS™ stylet). Our aim was to assess one-year outcomes of a clinical series of patients undergoing treatment with this device. Truncal reflux, where present, was treated initially, and RFA of IPVs was performed as a secondary procedure. Method Duplex ultrasound examinations were performed and the presence of IPVs documented. Results were compared with preoperative scans. IPVs were classified as closed, not closed/reopened or de novo. Results Of the 75 patients invited for follow-up, 53 attended at a median time of 14 months (range 11–25). Sixty-seven limbs were analysed (M:F 1:2.1, median age 62, range 25–81). Of the 124 treated IPVs, 101 were closed (82%). Clinical, aetiological, anatomical and pathological clinical score was improved in 49.3% limbs. IPV closure was reduced in patients with recurrent varicose veins compared with primary varicose veins (72.3% versus 87%, P = 0.056). Conclusion These results demonstrate the radiofrequency stylet device to be an effective treatment for IPVs.

Successful ultrasound-guided foam sclerotherapy for vulval and leg varicosities secondary to ovarian vein reflux: a case study

2010 ◽  
Vol 26 (1) ◽  
pp. 29-31 ◽  
Author(s):  
P Paraskevas
Keyword(s):  
Varicose Veins ◽  
Duplex Ultrasound ◽  
Symptomatic Improvement ◽  
Ovarian Vein ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Pelvic Congestion Syndrome ◽  
Vein Reflux ◽  
Pelvic Congestion

Pelvic varicose veins secondary to ovarian vein reflux are common and can present with clinical pelvic congestion syndrome (PCS). After assessment with duplex ultrasound and venography, treatment often involves surgical ovarian vein ligation and more recently embolization of the ovarian vein(s) followed by ultrasound-guided foam sclerotherapy (UGFS) of the pelvic tributaries. This paper presents one out of many PCS patients treated with UGFS of the pelvic tributaries alone, with clinically symptomatic improvement.

WP1-10 Prevalence of normal pressure hydrocephalus in falls clinic patients

2019 ◽  
Vol 90 (3) ◽  
pp. e4.2-e4 ◽  
Author(s):  
S Sennik ◽  
C Craven ◽  
L D’Antona ◽  
H Asif ◽  
W Dawes ◽  
...  
Keyword(s):  
General Hospital ◽  
Normal Pressure Hydrocephalus ◽  
Normal Population ◽  
District General Hospital ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
List Type ◽  
Ventricular Enlargement ◽  
Evans Index ◽  
One Year

ObjectivesPatients with idiopathic Normal Pressure Hydrocephalus (iNPH) present with Hakim Adams triad and radiological findings suggestive of iNPH. We compare the presence of clinical and radiological signs of iNPH present in patients presenting to falls clinic at a District General Hospital with the general population.DesignRetrospective analysis of patients referred to falls clinic (January 2017 to December 2017) and interpretation of CT or MRI head imaging with Evans index.SubjectsFalls clinic patients presenting to a District General Hospital outpatient clinic.MethodsRetrospective cohort of patients admitted to a single District General Hospital with falls and recent CT or MRI head. An Evans Index above 0.35 was used as an indicator of hydrocephalic ventricular enlargement.Results371 patients were seen in one year. 216 had previous CT or MRI head. 6.75% of all patients seen in falls clinic (11.6% who have had brain imaging) have hydrocephalic ventricular enlargement. This is compared to 4.5% in a study of patients aged 70 and over in a normal population.1ConclusionsPatients seen in Falls clinic have an increased probability of having radiological signs consistent with idiopathic normal pressure hydrocephalus.ReferenceJaraj D, Marlow T, Jensen C, Skoog I, Wikkelso C. Prevalence of idiopathic normal-pressure hydrocephalus. Neurology2014April 22;82(16):1449–1454.

Pre-operative haemoglobin estimation in paediatric ENT surgery

1993 ◽  
Vol 107 (12) ◽  
pp. 1146-1148 ◽  
Author(s):  
Timothy J. Hoare
Keyword(s):  
Haemoglobin Level ◽  
General Hospital ◽  
District General Hospital ◽  
Ent Surgery ◽  
Published Evidence ◽  
Mild Anaemia ◽  
One Year

Estimation of haemoglobin is still undertaken routinely before ENT surgery in many centres despite evidence that it is unnecessary, traumatic and expensive. The haemoglobin was estimated of all 372 children about to undergo ENT surgery in a busy district general hospital over a one year period. No child was noted to be clinically anacmic, and no child had a haemoglobin of less than 9 g/dl. Of 18 children with a haemoglobin level of 10.5 or less, 10 had their operations postponed and eight did not. There were no complications in the latter group. We can find no published evidence that operating on children with mild anaemia is unsafe. Ceasing routine pre-operative haemoglobin estimation would safely save an estimated £9000 per year in our unit.

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