Shimada Yasuyuki
Department of Cardiovascular Surgery, Yuri-Kumiai General Hospital, Japan.
J Rural Med. 2012;7(2):73-4. doi: 10.2185/jrm.7.73. Epub 2012 Nov 9.
We report a case of massive, life-threatening from a varicose lesion of the right lower extremity. An 81-year-old lady was brought to the emergency room at our hospital because of massive bleeding from her right leg. She had had high ligation of the right saphenous vein at another hospital 2 years ago. After hemostat and transfusion, she recovered from hemorrhagic shock. Three-dimensional enhanced computed tomography angiography revealed a residual right great saphenous vein and recurrent varicose lesion. We performed high ligation of the great saphenous vein and closed all of the residual perforators. The patient was discharged hospital 10 days after the surgery and experienced no bleeding episodes within 8 months after the surgery. Certain high ligation and elimination of perforators of the great saphenous vein in surgery for varicose vein of leg is necessary to prevent lethal bleeding.
我们报告一例因右下肢静脉曲张病变导致大量出血、危及生命的病例。一位81岁的女性因右腿大量出血被送至我院急诊室。两年前她在另一家医院接受了右大隐静脉高位结扎术。经过止血和输血治疗,她从失血性休克中康复。三维增强计算机断层血管造影显示右大隐静脉残留及复发性静脉曲张病变。我们进行了大隐静脉高位结扎并封闭了所有残留的穿支静脉。患者术后10天出院,术后8个月内未再发生出血事件。在腿部静脉曲张手术中,对大隐静脉进行高位结扎并消除穿支静脉对于预防致命性出血是必要的。