Varicose Veins

What are varicose veins?

Varicose veins are twisted, enlarged veins commonly affecting the lower limbs but any vein may become varicose.

How do they present?

  • Patients normally present with pain in the leg/legs which is more of a dull ache occurring towards the end of the day after prolonged standing. This pain is relieved by elevation.
  • They also develop swelling around the ankles and the legs feel very heavy.
  • They complain of discoloration around the ankle area.
  • Ulcers may form around the ankles.
  • They may complain of itching and night cramps.
  • Some obese people may have pain, swelling and heaviness for years with no visible varicose veins because of the obesity. They too have huge veins proven on color doppler.

Why do they occur?

It is because the valves within the veins become incompetent or spoilt and allow the blood to ferlux down the vein when standing and causing to dilate.

How is the diagnosis of varicose veins made?

  • First the patients present with a history of leg pain, swelling and heaviness in the legs. They may also complain of night cramps and itching.
  • On examination, we may find dilated veins along with color changes of the skin around the ankles. Some unfortunate patients may have ulcers around the ankles.
  • A provisional diagnosis of varicose veins is made.
  • The final diagnosis is on color doppler study which confirms reflux at the saphenofemoral junction in the groin or the saphenopopliteal junction behind the knee. The veins are dilated and may be tortuous. The perforators (connecting veins between the deep and superficial veins) are located and marked.