Ulcer adiposo-venosum – a therapeutic challenge

Summary

Background: The causal therapy of a venous leg ulcer is a therapeutic challenge in obese patients. Method: Based on a case report, the procedure is demonstrated: Sourcing can be used to detect ulcer-relevant varices even in severe obesity and to successfully foam-sclerose them. Results: The successful sclerotherapy of the sourcing-relevant varices has no effect on ulcer healing. Conclusion: Stigmata of chronic venous insufficiency are found in obese patients as a result of obesity, so that weight loss can be considered a causal therapy. In our case, one can speak of an ulcer adiposo-venosum.

English version available at: www.phlebologieonline.de

 

MissingLinkText

Keywords

Obesity - leg ulcers - chronic venous insuffi ciency - foam sclerotherapy

 

MissingLinkText

Interessenkonflikt

Die Autorin gibt an, dass kein Interessen konflikt besteht.

• Literatur

• 1 Obermayer A, Garzon K. Sourcing of superficial reflux in venous leg ulcers using duplex ultra sound. J VAsc Surg 2010; 52: 1255-1261.
• 2 Niemer M, Miesel A, Kahle B. Sourcing - welche Varize ist ulkusrelevant?. Phlebologie 2014; 43: 180-182.
• 3 Mensink GBM, Schienkiewitz A, Haftenberger M, Lampert T, Ziese T, Scheidt-Nave C. Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1), 2013 Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch Institut, Berlin. Bundesgesundheitsbl 2013; 56: 786-794.
• 4 Davies HO, Popplewell M, Singhal R, Smith N, Bradbury AW. Obesity and lower limb venous disease - The epidemic of phlebesity. Phlebology 2017; May; 32 (04) 227-233 doi: 10.1177/0268355516649333. Epub 2016 May 13.
• 5 Ageno W. et al. Body mass index is associated with the development of the post-throm-botic syndrome. Thromb Haemost 2003; 89 (02) 305-309.
• 6 Rabe E. Vein Bonn Study. Phlebologie 2006; 179e86.
• 7 Iannuzzi A, Panico S, Ciardullo AV, Bellati C, Cioffi V, Iannuzzo G. et al. Varicose veins of the lower limbs and venous capacitance in postmenopausal women: relationship with obesity. J Vasc Surg 2002; 36: 965e8.
• 8 Padberg Jr. F, Cerveira JJ, Lal BK, Pappas PJ, Varma S, Hobson RW. Does severe venous insufficiency have a different etiology in the morbidly obese? Is it venous?. J Vasc Surg 2003; 37: 79e85.
• 9 Danielsson G, Eklöf B, Grandinetti A, Kistner RL. The influence of obesity on chronic venous disease. Vasc Endovascular Surg 2002; 36: 271e6.
• 10 Willenberg T, Clemens R, Haegeli LM, AmannVesti B, Baumgartner I, Husmann M. The In fluence of Abdominal Pressure on Lower Extremity Venous Pressure and Hemodynamics: A Human In-vivo Model Simulating the Effect of Abdominal Obesity. Eur J Vasc Endovasc Surg 2011; 41: 849-855.
• 11 Willenberg T, Schumacher A, Amann-Vesti B, Jacovella V, Thalhammer C, Diehm N, Baumgartner I, Husmann M. Impact of obesity on venous hemodynamics of the lower limbs. J Vasc Surg 2010; 52: 664-668.
• 12 Van Rij AM, de Alwis CS, Jiang P, Christie RA, Hill GB, Dutton SJ, Thomson IA. Obesity and Impaired Venous Function. Eur J Vasc Endovasc Surg 2008; 35: 739-744.
• 13 Vlajinac HD, Marinkovic JM, Maksimovic MZ, Matic PA, Radak DJ. Body Mass Index and Primary Chronic Venous Disease - A Cross-sectional Study. Eur J Vasc Endovasc Surg 2013; 45: 293-298.
• 14 Engelberger RP, Indermühle A, Baumann F, Fahrni J, Diehm N, Kucher N, Egermann U, Laederach K, Baumgartner I, Willenberg T. Diurnal changes of lower leg volume in obese and non-obese subjects. Int J Obes 2014; 38: 801-805.