SURGICAL TREATMENT OF ACUTE VARICO-THROMBOPHLEBITIS OF THE GREAT SAPHENOUS VEIN WITH A THROMBUS HEAD FLOATING I NTO THE LUMEN OF THE DEEP VEIN WITH ITS SUBOCCLUSION, ACCORDING TO THE RESULTS OF ULTRASOUND DIAGNOSTICS OF THE VEINS OF THE LOWER EXTREMITIES

Abstract

Summary. Purpose of research. To show a rare variant of the clinical course of acute varicothrombophlebitis (AVT) in the basin of the great saphenous vein (GSV). To analyse the anamnestic data, symptoms, clinical manifestations, preoperative diagnosis, features of surgical intervention, and postoperative management in a patient with acute varicothrombophlebitis (AVT), who had a complication in the form of a floating thrombus head passing from the trunk of the VCF into the lumen of the common femoral vein (CfV) with spread along the external iliac vein (EIFV) with subocclusion of its lumen. Materials and methods. The article analyses a case of complicated course of acute varicothrombophlebitis in the basin of the VCF, which had a complication in the form of a floating thrombus head moving from the trunk of the VCF into the lumen of the common femoral vein (CFV) with spread along the external iliac vein (EIFV) with subocclusion of its lumen. This conclusion was detected only after performing urgent ultrasound Dopplerography (USDG) of the superficial and deep veins of the lower extremity. Research results and discussion. The patient had a history of complaints, namely, redness, compaction, pain and swelling along the left side of the IVC trunk, which appeared several days before admission to the hospital with negative dynamics during this time in the form of spreading changes along the limb to its upper parts. She sought a consultation with a vascular surgeon. A thorough medical history and an urgent ultrasound examination of the lower extremity veins allowed us to diagnose the patient with complicated acute varicothrombophlebitis. She was admitted urgently with acute varicothrombophlebitis, as well as signs of edema and lymphostasis of the soft tissues of the lower leg and thigh, which increased over time. The course of surgical treatment was predicted, and thrombectomy from the external iliac and common femoral vein and left crossectomy were performed. The patient’s condition improved and she was discharged from the hospital. Conclusions. Patients with varicose veins of the lower extremities should be monitored and treated by specialist vascular surgeons. Careful history taking in this group of patients and emergency ultrasound Doppler of the lower extremities allowed us to establish the correct diagnosis in the preoperative period. Specialists’ understanding of the possibilities of ultrasound Doppler ultrasound of the veins of the lower extremities, as well as compliance with the full examination protocol for ultrasound Doppler veins, allows us to provide detailed information to determine the most effective treatment tactics and prevent complications of the disease.