Role of Grey Scale and Doppler Ultrasound in Evaluation of Abdomino-Pelvic Causes of Lower Limb Varicose Veins | ||
| The Egyptian Journal of Hospital Medicine | ||
| Volume 101, Issue 1, October 2025, Pages 5579-5586 PDF (805.84 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2025.466081 | ||
| Abstract | ||
| Background: Varicose veins, if left untreated, can result in ulcers, bleeding, and skin changes, and severe forms may indicate chronic venous insufficiency. Aim: This study aimed to evaluate the role of Doppler ultrasound in detecting abdomino-pelvic causes of lower limb varicosities and to propose grading systems for key pelvic venous insufficiency syndromes. Methods: A prospective study that was conducted on 41 patients clinically suspected to have abdomino-pelvic causes of lower limb varicosities. Patients were referred from Vascular Surgery and Obstetrics & Gynecology Departments, Faculty of Medicine, Menoufia University Hospitals to the Radiodiagnosis and Medical Imaging Department for Duplex ultrasound examination. Detailed demographic, occupational, and risk factor data were collected using Doppler ultrasound (both abdominal and transvaginal approaches). Results: Common symptoms included pelvic pain (43.9%) and leg swelling/heaviness (41.5%). Venous reflux was nearly universal (95.1%). Doppler identified dilated gonadal veins in 41.5%, left renal vein compression in 36.6%, reversed flow in 39%, internal iliac vein reflux in 19.5%, and May-Thurner syndrome in 14.6%. Moderate to severe grades were predominant across all syndromes. Nutcracker syndrome was definitive in 4.9% and suspected in 36.6%. Significant overlap between venous insufficiency syndromes was observed, with pelvic pain and lower limb varicosities frequently coexisting. Conclusion: Abdomino-pelvic venous disorders are important and under-recognized cause of lower limb varicosities, often presenting with overlapping syndromes and recurrent varicosities. Doppler ultrasound is a valuable, non-invasive diagnostic tool for identifying these conditions, enabling earlier diagnosis and improved treatment planning. Implementing systematic pelvic venous assessment may enhance diagnostic accuracy and optimize outcomes in patients with atypical or recurrent varicose veins. | ||
| Keywords | ||
| Varicose veins; Pelvic venous insufficiency; Doppler ultrasound; Lower limb varicosities | ||
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