Wing vein abnormality analysis in honeybee (Apis mellifera L. 1758) populations from Iran.

The insect wing is one of the most important characteristics that allowed insects to occupy most of the habitats on the planet. Honeybee wings has been the subject of studies on the venation abnormalities. A total of 424 honeybees from 14 locations were collected and all four wings were removed and examined for 19 abnormalities on the forewings and 6 abnormalities on the hindwings. In general, supernumerary veins were the most common abnormalities seen and abnormalities no. 23, 2, 6, 1, 5, 21, 10, 13 had the highest and abnormalities no. 11, 17, 18, 19, 20, and 25 had the lowest frequencies. All of the abnormalities had similar frequencies in the right and left wings in the population. In terms of correlation between 25 abnormalities, abnormality pairs AB3-AB13, AB6-AB7, AB7-AB8, AB10-AB12, AB16-AB17 on the forewing and AB2-AB23, AB12-AB20, AB12-AB24, AB13-AB21, AB16-AB25, and AB17-AB25 between the forewing and hindwing show significant positive correlations and abnormality pairs AB4-AB5, AB7-AB15 and AB8-AB9 on the forewing show significant negative correlations with each other. In terms of the differential occurrence of abnormalities , a few locations differed significantly from other locations. This study provides some insights into the nature of these abnormalities on the honeybee wings.

Venous malformations in children: comparison between magnetic resonance imaging and histopathological findings.

BACKGROUND: Among low-flow vascular malformations, venous malformations are relatively frequent. The pathological patterns vary in severity and are generally characterized by dilated vessels and low-flow blood that over time can organize into phleboliths. Sometimes small capillary and/or lymphatic vessels may be associated, micro- and/or macro-shunts may form alone or in different combinations, and finally adipose tissue may be interposed between the malformed vessels. Magnetic resonance imaging (MRI) is a crucial examination for confirming venous malformations because it can accurately identify different features of the lesions. OBJECTIVE: The aim of our study was to compare MRI and histopathological findings of venous malformations in children to assess the possibilities and limitations of MRI. MATERIALS AND METHODS: In a retrospective study, two observers independently evaluated the contrast-enhanced MRI of 26 children with venous malformations. Several radiological parameters were considered and compared with histopathological findings. The agreement between the interobserver radiological evaluation and between histopathological and radiological diagnosis was verified using Cohen's kappa. RESULTS: MRI interobserver agreement was excellent for micro-shunts and good for the remaining findings. The radiological-pathological agreement was perfect for the presence/absence of phleboliths and of macro-shunts and almost perfect for the presence of intralesional adipose tissue, lymphatic component, and micro-shunts. CONCLUSION: MRI in venous malformations can detect the presence of phleboliths, adipose tissue, and lymphatic components with excellent accuracy and good to excellent interobserver agreement. Furthermore, MR angiography can detect micro-shunts in simple and combined venous malformations with substantial agreement with histopathological findings.

Frequency of the prominent transverse nasal root vein in children.

BACKGROUND: The presence of a vascular, blue linear discoloration on the nasal root of infants and young children is a frequent incidental feature, rarely reported in the medical literature. It is related to the trajectory of the transverse nasal root vein (TNRV). OBJECTIVE: To study the frequency and clinical characteristics of the vascular discoloration of the nasal root in children. METHODS: A prospective study was performed to address the presence or absence of vascular discoloration of the nasal root in all children under 6 years of age attending a pediatric dermatology clinic from November 2022 to November 2023. Data on age and skin phototype (Fitzpatrick classification I-VI) were also collected. RESULTS: Of 701 patients examined, 345 (49.2%) presented with a vascular discoloration of the nasal root. This was present in 97 of 193 (50.3%), 127 of 261 (48.7%), and 121 of 247 (49.0%) patients for the age groups 0-1, 1-3, and 3-6 years, respectively. The presence of vascular discoloration of the nasal root was more frequent in patients with lighter Fitzpatrick skin phototypes: 49 of 69 (71.0%) phototype II, 157 of 290 (54.1%) phototype III, and 137 of 337 (40.7%) phototype IV. CONCLUSIONS: A vascular discoloration of the nasal root is a frequent skin feature in infants and children, persisting at least until the age of 6. It does not constitute any medical problem aside from cosmetic concern and parents can be reassured of its benign nature. We propose the medical term "prominent TNRV" to describe this condition.

Recurrent hematuria involving urinary system with Klippel-Trenaunay syndrome: A case report.

RATIONALE: Klippel-Trenaunay syndrome (KTS) is a rare congenital venous malformation, it had been found to be caused by mutations of the phosphatidylinositol 4, 5-diphosphate 3-kinase catalytic subunit alpha (PIK3CA) gene. Currently KTS is defined as a triad of skin wine pigmented spots, varicose veins and malformations of the lower extremities, and hypertrophy of bone and soft tissue, involving urinary system up to 6% to 30%. When the urinary system is involved, KTS is often presented as painless massive gross hematuria. PATIENT CONCERNS: This article describes a woman who was hospitalized with painless massive gross hematuria. Physical examination revealed significant hypertrophy of the right lower limb with varicose veins, port-wine stains in the skin, and right perineal hemangiomatous changes with swelling. The patient was admitted to hospital 4 times for repeated hematuria and infection. DIAGNOSES: By physical examination, CT urography, ureteroscopy and cystoscopy, the patient was diagnosed to have Klippel-Trenaunay syndrome, involving the urinary system. INTERVENTIONS: The patient hematuria improved after multiple indwelling D-J tubes and anti-inflammatory treatment. OUTCOMES: The final symptoms of hematuria improved significantly, follow-up so far has not recurred. LESSONS: This case presents the possibility of painless gross hematuria with KTS. Most of patients can be improved by conservative treatment. Cystoscopic laser therapy is the preferred treatment for poor bleeding control. Cystectomy and nephrectomy should be considered when life-threatening.

Blood within the bone: orbital intraosseous venous malformation.

PURPOSE: Description of clinical features, radiological characteristics, and management strategies in primary orbital intraosseous venous malformation (OIVM) with pertinent literature review. METHODS: A retrospective analysis including clinical, radiologic, operative, and histopathological data of six cases of histopathologically proven OIVM was done. A comprehensive literature review was conducted using online databases and augmented with manual search to identify reported cases of OIVM. RESULTS: Study data showed five females and one male in young to middle-age group, with an average age of 30 years (range: 20-48 years). Proptosis was noted in five cases (83.33%), and the duration of symptoms ranged from 6 months to 10 years. Frontal and zygomatic bones were most frequently affected and expansile bony lesion was the most common CT scan finding. Three patients underwent pre-operative embolization of feeders followed by en bloc excision of mass and surgical reconstruction (50%); one patient was managed with partial excision (16.66%) while two were regularly followed-up after incision biopsy (33.33%). Histopathology revealed vascular spaces with endothelial lining, separated by bony trabeculae in all patients. Follow-up periods ranged from 6 to 48 months and no recurrence or progression were noted. CONCLUSIONS: OIVM is an exceptionally rare disorder with a gradually progressive benign course. Ophthalmologists need to be mindful of this entity during patient evaluation as it has propensity for large volume blood loss intra-operatively, owing to its vascular nature. Complete excision with reconstruction of resultant defect is the preferred treatment strategy and without known recurrence.

Leiomiosarcoma de vena cava / Vena cava leiomyosarcoma

Caso clínico: se presenta el caso de un varón de 64 años con sospecha de leiomiosarcoma de vena cava inferior (VCI) tratado con radioterapia neoadyuvante previa a resección quirúrgica en bloque tumoral y de VCI con reconstrucción mediante injerto de PTFE anillado, seguido de quimioterapia. Discusión: el leiomiosarcoma de VCI es una patología maligna muy infrecuente, de mal pronóstico y que requiere un manejo multidisciplinar. Representan la localización más frecuente de los leiomiosarcomas venosos, tienen predilección por el sexo femenino y una edad media de presentación entre 50 y 60 años. El síntoma más frecuente es el dolor abdominal, aunque muchos son asintomáticos. La prueba diagnóstica de elección es la RM y el tratamiento se basa en la resección quirúrgica, no estando aún claramente definido el papel de la radio y quimioterapia.(AU)

Case report: we present the case of a 64-year-old man with suspected inferior vena cava leiomyosarcoma (IVC) treated with neoadjuvant radiotherapy, tumor and IVC overall surgical resection with a ringshaped PTFE graft reconstruction, followed by chemotherapy. Discussion: IVC leiomyosarcoma is a very infrequent malignant disease, its prognosis is dark and requires multidisciplinary management. They represent the most frequent location of venous leiomyosarcomas, have a predilection for the female sex and a mean age of presentation between 50 and 60 years. The most frequent symptom is abdominal pain, although many are asymptomatic. The diagnostic test of choice is MRI and treatment is based on surgical resection, the role of radio and chemotherapy is not clearly defined yet.(AU)

Placas eritematovioláceas en miembro inferior / Violaceous Erythematous Plaques on a Lower Limb

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Hallazgos por imagen de malformación de Abernethy tipo II en paciente de 12 años / Image finding of Abernethy type II malformation in 12 year old patient

Las malformaciones del sistema venoso abdominal son alteraciones vasculares raras. La incidencia de esta afección se estima en uno de cada 30,000 nacimientos y se asocian con malformaciones gas- trointestinal, genitourinaria, ósea y cardiovascular. En el 2018 se ha registrado en la literatura mundial 39 casos de Abernethy tipo I y 22 casos de Abernethy tipo II. CASO CLÍNICO paciente femenino de 12 años con antecedente de hipertensión portal tratada hace 2 años, con historia de malestar general e ic- tericia, acudió a centro privado para realizarse estudios complementarios. Un ultrasonido Doppler por- tal evidenció una lesión isoecogénica al parénquima hepático en el aspecto inferior del lóbulo derecho. Se continuó la evaluación realizando una tomografía en la cual se observó: configuración anómala del sistema venoso portal; la vena esplénica y mesentérica superior se encuentran dilatadas, además se evidenció confluencia portoesplénica elongada, en la cual derivan dos trayectos portales, uno de ellos drenando la lobulación hepática antes descrita y la segundo se comunica con el sistema venoso portal hepático derecho, demostrando tortuosidad de su trayecto, con estenosis de su porción proximal. Los hallazgos antes descritos sugieren malformación vascular del sistema venoso portal-esplácnico, que causa derivación porto-sistémica en relación a malformación de Abernethy tipo II. En conclusión se recomienda el diagnóstico precoz. El examen preferente es el ecodoppler con posterior confirmación mediante angiotac abdominal. El tratamiento es sumamente importante pues su retraso puede devenir en lesiones irreparables hasta la insuficiencia hepática y muerte...(AU)

Variz Intra-Óssea ­ um achado raro diagnosticado pela ressonância magnética / Intraosseous Varicose Vein ­ A rare finding diagnosed by magnetic resonance imaging

Introdução: As varizes são veias que após submetidas a períodos de pressão aumentada no sistema venoso periférico se tornam dilatadas, tortuosas e alongadas. Pacientes acometidos irão referir dor no membro, além de sinais de insuficiência venosa. O exame de imagem comumente utilizado é o ultrassom com Doppler, no entanto, na presença de anomalias de drenagem venosa intraóssea, deve-se preferir a ressonância magnética. Objetivo: Relatar um caso e revisar a literatura acerca desta lesão incomum. Materiais e Métodos: Revisão do prontuário do paciente no Hospital América, registro fotográfico do método diagnóstico e revisão da literatura. Resultados: Homem de 46 anos com dor e queimação constantes, além de edema na perna e no pé esquerdos há dois meses Ao exame físico apresenta edema da perna, tornozelo e pé esquerdos, com discreto aumento de temperatura ao toque, sem alteração da coloração da pele. A ressonância magnética demonstra varicosidades das veias tibiais posteriores com comunicação através de veia perfurante com varicosidade da veia intraóssea posterior da tíbia ­ variz intraóssea. Conclusão: Este relato demonstra a dificuldade de diagnosticar a variz intra-óssea que, além de ser uma lesão rara, é diagnosticada apenas pela ressonância magnética.

Introduction: Varicose veins are veins that after being submitted to high pressure on the peripheral venous system become dilated, tortuous and elongated. Patients affected will report pain and venous insufficiency signs in the area. The imaging exam commonly used is the Doppler ultrasound, however, when in front of an intraosseous venous drainage anomaly ­ intraosseous varix, magnetic resonance should be preferred. Objective: Report a case and review the literature about this uncommon lesion. Materials and Methods: We carried out a review of medical records at Hospital América, a photographic record of diagnostic methods, and a review from the literature. Results: A 46-year-old man with constant pain and burning, as well as edema in his left leg and foot for two months. On physical examination, he had edema in his left leg, ankle, and foot, with a slight increase in temperature at the touch, without changing the skin color. Magnetic resonance imaging shows varicosities of the posterior tibial veins with communication through a perforating vein with varicosity of the posterior tibial intraosseous vein - intraosseous varicose vein. Conclusion: This report demonstrates the difficulty of diagnosing intraosseous varices, which, in addition to being a rare lesion, are diagnosed only by magnetic resonance imaging.

Five veins at the deep inguinal ring: can they reduce the chances of indirect inguinal hernia and increase the chances of varicocele? / Cinco venas en el anillo inguinal profundo. ¿pueden reducir las probabilidades de una hernia inguinal indirecta y aumentar las posibilidades de varicocele?

Complete duplication of testicular veins is a rare phenomenon. However, a few cases of duplication of gonadal veins have been reported. Here, I report a case of unusual formation and termination of the right testicular vein in an adult male cadaver. Five veins arose from the pampinniform plexus and entered the abdomen through the deep inguinal ring. The most medial among the five was large (3 mm in diameter) and it continued as a testicular vein and opened into the right edge of the inferior vena cava, 1 cm above the union of the common iliac veins. The other four veins were about 1 mm in diameter and they united to form two veins in front of the lower part of the right psoas and iliacus muscles (about 2 cm above the deep inguinal ring) and the two veins united to form upper testicular vein, 4 cm above the deep inguinal ring. This testicular vein was 3 mm in diameter and it opened into the inferior vena cava, 4 cm above the union of common iliac veins. Having five veins at deep inguinal ring might increase the chances of varicocele and decrease the chances of indirect inguinal hernia.

La duplicación completa de las venas testiculares es un fenómeno raro. Sin embargo, se han reportado algunos casos de duplicación de venas gonadales. En el presente trabajo se informa un caso de formación y terminación inusual de la vena testicular derecha en un cadáver de un hombre adulto. Cinco venas surgieron del plexo pampiniforme y penetraron en el abdomen a través del anillo inguinal profundo. El más medial entre los cinco fue de gran tamaño (3 mm de diámetro) y continuó como una vena testicular y se abrió hacia el margen derecho de la vena cava inferior, 1 cm por encima de la unión de las venas ilíacas comunes. Las cuatro venas restantes eran de 1 mm de diámetro aproximadamente, y se unieron para formar dos venas frente a la parte inferior de los músculos psoas e ilíaco derechos (aproximadamente 2 cm por encima del anillo inguinal profundo). Se unieron dos venas para formar la vena testicular superior, la cual medía 3 mm de diámetro y se abría hacia la vena cava inferior, 4 cm por encima de la unión de las venas ilíacas comunes. Cinco venas en el anillo inguinal profundo podrían aumentar las posibilidades de varicocele y disminuir las posibilidades de una hernia inguinal indirecta.

Aneurismas venosos asociados a malformaciones linfáticas / Venous aneurysms associated with lymphatic malformations

Objetivos. Analizar y describir la asociación entre el desarrollo de aneurismas venosos (AV) de grandes troncos en pacientes con malformaciones linfáticas (ML). Material y métodos. Estudio retrospectivo de los pacientes de nuestro centro entre 1993-2014, y análisis descriptivo de la asociación AV y ML. Resultados. Se identificaron 6 pacientes, 50% mujeres, con una ML confirmada mediante prueba de imagen y una dilatación aneurismática de un tronco venoso. Los pacientes tenían edades entre 20 semanas-12 años y las ML se encontraban intratorácicas (n= 4), intratorácicas-cervical (n= 1) y en miembro inferior (n= 1); y las venas dilatadas en sus proximidades, siendo afectadas con mayor frecuencia los grandes vasos mediastínicos (vena cava superior- innominada (n= 1), confluencia venosa subclavioyugular (n= 2), vena cava superior (n= 2) y la vena poplítea (n= 1)). Se intervinieron n= 4, no pudiéndose extirpar completamente en 2 casos. Los niños que presentaron un diagnóstico prenatal de la malformación linfática presentaban una dilatación aneurismática de una gran vena en el control neonatal de la malformación (n= 2). En cambio, los pacientes con diagnóstico tardío de ML no presentaban dilatación vascular hasta pasados varios años (media 6 años). Ningún AV ha iniciado tratamiento antiagregante, y no han aumentado bruscamente su tamaño, uno desarrolló un trombo y posteriormente un tromboembolismo pulmonar, y otro debutó una insuficiencia mitral necesitando un recambio valvular mitral. Conclusión. El AV es una entidad poco común, y no existe algoritmo terapéutico, siendo una máxima el tratamiento individualizado de cada paciente

Objectives. To analyze and describe the association between the development of venous aneurysms of the mayor vessels in patients with lymphatic malformations. Material and methods. Retrospective review of patients diagnosed with both VA and LM from 1993 to 2014 and a descriptive analysis of clinical course was performed. Results. We found 6 patients, 50% females, who had LM and VA confirmed with imaging techniques. All were diagnosed between 20 weeks- 12 years of age. LM were found within the thoracic cavity (n= 4), intrathoracical-cervical area (n= 1) and lower extremities (n= 1). In most cases the dilated veins were near the LM and thus, the mediastinal vessels were most commonly affected (superior vena cava-innominated (n= 1), venous jugulosubclavian confluence (n= 2), superior vena cava (n= 2) and popliteal vein (n= 1)). A total of 4 patients required surgical treatment of the LM with complete excision in 2 of the cases. Patients with a prenatal diagnosis of lymphatic malformation were most likely to present venous aneurysms at birth (n= 2), however the remaining patients (without prenatal diagnosis) developed them later on (average 6 years). Unlike lower extremity aneurysms, none of these aneurysms grew or required antiplatelet therapy; local thrombosis developed in one which resulted in pulmonary thromboembolism and one developed mitral valve insufficiency (regurgitation?) which required valve replacement. Conclusion. VA is extremely rare, and there is not therapeutic algorithm, therefore treatment should be individualized

Un caso de síndrome de Adams-Oliver con venas congénitas, dilatadas y persistentes en el cuero cabelludo / A case of Adams-Oliver syndrome with congenital and persistent dilated veins in the scalp

El síndrome de Adams-Oliver es un desorden congénito raro, caracterizado por la presencia de aplasia cutis congénita y defectos terminales transversos de los miembros. Comunicamos el caso de una niña de 4 años de edad con síndrome de Adams-Oliver que presenta venas congénitas, tortuosas y dilatadas en el cuero cabelludo, aplasia cutis congénita con defectos parciales del hueso craneal subyacente, calcificaciones intracraneales y anomalías leves de los pies.

Adams-Oliver syndrome is a rare congenital disorder characterized by aplasia cutis congenita and terminal transverse limb defects. We report a case of a 4-year-old girl with Adams-Oliver syndrome with congenital dilated and tortuous scalp veins, aplasia cutis congenita with partial underlying skull defects, intracranial calcifications, and mild foot anomalies.

Tratamento a laser das malformações vasculares venosas / Laser treatment of venous malformations

OBJETIVO: Avaliar se o tratamento das malformações vasculares venosas congênitas realizado com o emprego da tecnologia laser oferece clareamento ou desaparecimento das lesões com elevado grau de satisfação informado pelos pacientes e observado pelo médico. MÉTODOS: O estudo retrospectivo reuniu 26 pacientes, portadores de malformação vascular venosa, dos quais 73,07 por cento eram do sexo feminino e que foram tratados com o aparelho PhotoDerm®. O tratamento das malformações vasculares necessitou uma média de 6,43 sessões, com intervalos de seis a oito semanas. Os pacientes incluídos neste estudo apresentavam pele tipo II (57,40 por cento) e tipo III (42,30 por cento), conforme classificação de Fitzpatric. A idade média variou de 14 a 61 anos, com média de 36,70 anos. Os dados foram obtidos através do preenchimento de protocolo informado pelo paciente. RESULTADOS: Foi informado elevado grau de satisfação (96,16 por cento) e apenas um caso (3,84 por cento) parcialmente satisfeito, considerando o clareamento ou desaparecimento das lesões. Houve desaparecimento das lesões avaliado pelo profissional médico em 80,76 por cento dos casos e em 19,24 por cento apenas clareamento. CONCLUSÃO: O tratamento das malformações vasculares venosas com o Photo-Derm® é seguro e eficiente tendo proporcionado elevado grau de satisfação dos pacientes assim como bons resultados em relação ao desaparecimento das lesões.

OBJECTIVE: To evaluate whether treatment of venous congenital vascular malformations with the use of laser technology provides lightening or disappearance of lesions with a high degree of satisfaction reported by patients and observed by the physician. METHODS: A retrospective study gathered 26 patients suffering from vascular malformation, of which 73.07 percent were female and were treated with the PhotoDerm® device. The treatment of vascular malformations needed an average of 6.43 sessions, with intervals of six to eight weeks. Patients included in this study had skin type II (57.40 percent) and type III (42.30 percent), according to the Fitzpatric's classification. The mean age ranged from 14 to 61 years, averaging 36.70 years. Data were obtained through the completion of an informed protocol by the patient. RESULTS: High satisfaction rates were reported (96.16 percent) and only one case (3.84 percent) was partially satisfied when considering lightening or disappearance of lesions. When evaluated by medical professionals, lesions disappeared in 80.76 percent and became lighter in 19.24 percent. CONCLUSION: The treatment of venous vascular malformations with Photo-Derm® is safe and effective as it offered a high degree of patient satisfaction and good results in the disappearance of the lesions.

Ultrasonografía Doppler-color en el diagnóstico de las anomalías vasculares de las partes blandas superficiales en pediatría / Color Doppler ultrasonography in the diagnosis of vascular anomalies of the superficial soft tissue in children

Las anomalías vasculares de las partes blandas superficiales son frecuentes en el niño y se han clasificado en hemangiomas y malformaciones vasculares, según sus manifestaciones clínicas y hallazgos histológicos. La mayoría corresponde a hemangiomas, se presenta en el recién nacido, desaparece espontáneamente con el tiempo y sólo algunos de ellos requerirán de evaluación médica. Es importante especificar el tipo de lesión vascular para definir el tratamiento, lo que en la mayor parte de los casos es posible con los hallazgos clínicos. Sin embargo, a veces es necesario recurrir a estudios de imágenes para precisar el diagnóstico y los métodos más utilizados son la Ultrasonografía (US) Doppler-color; Resonancia magnética (RM) y Angiografía. La US Doppler-color es un método sencillo, inocuo, no invasivo, que permite diferenciar las lesiones superficiales de aquellas profundas y además permite evaluar la vascularización de la lesión y, de esta manera, lograr una adecuada aproximación diagnóstica. También permite seleccionar aquellos casos que requerirán de métodos más sofisticados, como RM o angiografía. El objetivo de esta revisión es mostrar la utilidad de la US Doppler en el estudio de las anomalías vasculares de las partes blandas superficiales en el niño.

Vascular anomalies of superficial soft tissues are frequent in children and have been classified in hemangiomas and vascular malformations, depending on clinical and histological findings. Most correspond to hemangiomas, present in the newborn period, which disappear spontaneously with time and only some may require an imaging evaluation. It is important to specify the type of vascular anomaly in order to define management, which in most cases is possible with just clinical findings. Nevertheless, some cases may require imaging studies to define diagnosis, and the most utilized methods are Doppler ultrasonography (US), magnetic resonance Imaging (MRI) and angiography. Doppler US is a non invasive, harmless and simple method which allows to differentiate between deep and superficial lesions. It also permits to evaluate vascularization and in this manner; achieve an adequate diagnosis and select those cases that will require more sophisticated methods like MRI or angiography. The main objective of this review is to show the role of Doppler US in the study of superficial soft tissue vascular anomalies in children.

Malformaciones Vasculares / Vascular malformation

Las malformaciones vasculares son anomalías presentes siempre desde el nacimiento que, al contrario de los hemangiomas, nunca desaparecen; pueden crecer durante toda la vida por hipertrofia. Según la clasificación de la ISSVA, las malformaciones vasculares se dividen en función del vaso afectado en capilares o venulares, venosas, linfáticas, arterio-venosas y combinadas o complejas. Cada una de ellas, con unas peculiaridades clínicas y hemodinámicas definitorias.

Vascular malformations are anomalies always present at birth that, contrary to hemangiomas, never regress; and may hypertrophy during lifetime. According to the ISSVA classification, vascular malformations are divided, depending on the affected vessel, into capillary or venular, venous, lymphatic, arteriovenous and combined or complex; each with certain defining clinical and haemodynamic peculiarities.

Retro-pubic vascular anomalies: a study of abnormal obturator vessels

Variations in the vascular pattern are common in the retro-pubic region. These anomalies are chiefly concerned with the origin and course of the obturator vessels; especially the venous channels. The present study is an effort to observe the incidences of abnormalities of these vessels for their significance in several clinical contexts. The study investigates the frequencies of (a) the presence of abnormal obturator vessels (vasa corona mortis), (b) the occurrence of abnormal obturator veins (venous corona mortis) and (c) the different patterns of the origin of the abnormal obturator arteries. It is important to note that although the percentages of occurrences of these anomalies found in the study are different from previous reports, they are nevertheless significant owing to their obvious clinical implications (AU)

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Malformaciones venosas. Importancia de su diagnóstico y tratamiento en la infancia / Venous malformations. Diagnosis and treatment during the childhood

Introducción. La malformación venosa congénita (MVC) es la anomalía vascular de bajo flujo más frecuente en la infancia, aunque en muchas ocasiones no puede evidenciarse al nacimiento y se hace clínicamente más llamativa en edades tardías. Característicamente no involuciona sino que manifiesta un desarrollo progresivo y variable a lo largo del tiempo. Pacientes y métodos. Realizamos un estudio retrospectivo de la historia clínica de 72 pacientes diagnosticados y tratados de MVC en nuestro Servicio en los últimos 15 años. La edad de los pacientes oscilaba entre los 5 días y los 26 años, con una proporción de mujeres de 2 sobre uno. La localización más frecuente de las malformaciones fue en las extremidades seguida de las que asentaban en cabeza y cuello. No se incluyeron en el estudio aquellos pacientes que tenían lesiones mixtas y en el SNC. Resultados. Los síntomas fueron, por orden de frecuencia, el dolor (60% de los pacientes), la tromboflebitis, el aumento de tamaño de la extremidad, los fenómenos dérmicos, la distrofia ósea y, en último término, la coagulopatía de consumo. En prácticamente todos los enfermos la sintomatología se desencadenó o se intensificó en relación a traumatismos, infecciones y cambios hormonales. El diagnóstico se realizó mediante valoración clínica, ecoDoppler en todos los pacientes para descartar alto flujo y RN como estudio de extensión. No se realizó arteriografía de rutina y en algunos casos se (..) (AU)

Introduction. Congenital venous malformations are the most common slow-flow vascular abnormalities during childhood. Although they are usually present at birth, clinical evidence often appear during late childhood. This type of malformations do not disappear, and they grow progressively during years. Patients and methods. We present a retrospective study based on the medical records of 72 patients treated in our Department during the last 15 years. Patients` age at the diagnosis was 5 days to 26 years. Malefemale relationship was 2:1. The most frequent locations were Upper and lower extremities, followed by head and neck. We do not include in this study those patients with mixed lesions involving CNS or abdomen. Results. Main symptoms were: pain, 60%; thrombophlebitis, growing size of the extremities, dermis lesions, osseous dystrophy and chronic coagulopathy. Symptoms worsening was related to trauma, infections and hormonal changes. Clinical course was the clue for the diagnosis. Eco-doppler was useful to study the flow of the lesion. MRI was employed to determinate the limits of the lesion. We did not perform arteriography, and phlebography was used as a diagnostic and therapeutic tool. Plain X-rays showed phleboliths in most of patients and osseous changes in a group of six patients. Treatment was conservative and palliative using elastic stockings, pain therapy and thromboembolism prophylaxis This was the only treatment in irresectable lesions and in those cases without functional abnormalities. Surgery and sclerotherapy were the main curative treatments. Sclerotherapy was employed in cases of intramuscular and in delimited lesions. Ethanol and Ethibloc (Sodic Amidotrozoate) were the sclerosant agents. We performed surgery in cases of cutaneous complications, localized muscular lesions and in cases of recurrences after sclerotherapy. Ablative surgery was followed by reconstructive attempts using cutaneous and dermal artificial grafts. Conclussions. Congenital venous malformations must be diagnosed and treated during childhood. Conservative and resective treatments are useful in different cases. Accurate diagnosis and treatment improve long term results (AU)