Jaworucka-Kaczorowska Aleksandra, De Maeseneer Marianne
Centre of Phlebology and Aesthetic Medicine, Gorzów Wlkp., Poland.
Department of Dermatology, Erasmus Medical Centre, Rotterdam, the Netherlands.
EJVES Vasc Forum. 2025 Jan 8;63:53-56. doi: 10.1016/j.ejvsvf.2024.12.004. eCollection 2025.
Extrapelvic varices of pelvic origin, such as vulvar varices, and lower extremity varicose veins (VVs) of pelvic origin are being diagnosed with increasing frequency. A proper management strategy, including history, physical examination, duplex ultrasound (DUS) of the lower extremities, DUS of pelvic escape points, selection of appropriate treatment, and post-treatment care, is essential for good patient outcomes and satisfaction.
A non-pregnant, 27 year old female presented with prominent vulvar varices in combination with right sided VVs on the anterior and medial thigh, calf, and buttock. She was successfully managed by bottom up treatment with ultrasound guided foam sclerotherapy. The bottom up technique involves treatment of VVs of pelvic origin by direct puncture of the pelvic escape points and associated VVs, without embolisation of the pelvic veins.
This case illustrates successful bottom up treatment in accordance with recent guidelines in a female patient with extensive VVs of pelvic origin.
盆腔源性的盆腔外静脉曲张，如外阴静脉曲张，以及盆腔源性的下肢静脉曲张（VV）的诊断频率日益增加。适当的管理策略，包括病史、体格检查、下肢双功超声（DUS）、盆腔逃逸点的DUS、选择合适的治疗方法以及治疗后护理，对于获得良好的患者预后和满意度至关重要。
一名27岁非妊娠女性，表现为明显的外阴静脉曲张，同时右侧大腿前内侧、小腿和臀部存在下肢静脉曲张。通过超声引导下泡沫硬化疗法的自下而上治疗，她获得了成功治疗。自下而上技术是通过直接穿刺盆腔逃逸点及相关的静脉曲张来治疗盆腔源性的静脉曲张，而不栓塞盆腔静脉。
本病例表明，对于一名患有广泛盆腔源性静脉曲张的女性患者，按照最新指南进行自下而上的治疗取得了成功。
