Diagnosis of varicose veins

Varicose veins refer to tortuous engorged veins on the lower extremities. Although this is a common condition observed in clinical practice, objective diagnosis is important for optimal treatment.Current Concepts: Thorough physical examination is the first key step for diagnosis of varicose veins. Both legs should be examined between the inguinal region and the feet with the patient in an erect position. The presence and location of venous reflux should be confirmed using duplex ultrasonography (DUS), which serves as a simple, non-invasive modality to assess both the anatomy and physiology of leg veins. Reflux is defined as duration of retrograde flow greater than 0.5 seconds in superficial veins, 0.35 seconds in perforating veins, and 1.0 seconds in deep veins. Computed tomography venography can be used in selective cases as a complementary tool to obtain objective images of all varicose veins; however, this imaging modality cannot confirm venous reflux.Discussion and Conclusion: DUS is a key diagnostic tool for varicose veins. However, DUS results are operator dependent; therefore, this procedure should be performed by experienced technologists or clinicians, based on guidelines. The location and duration of reflux should be recorded.

Tuberculosis of Cystic Duct Lymph Node Associated with Cholecystitis / 대한소화기학회지

Tuberculosis of the cystic duct lymph node is very rare. Only four cases have been reported in the literature. This paper presents the case of a young male patient with a tuberculous cystic duct lymph node and chronic cholecystitis, who was diagnosed with cystic duct stones and a gall bladder polyp preoperatively.

Successful Conservative Management of Hepatic Portal Venous Gas due to Anastomosis Leakage After a Sigmoidectomy

In past decades, hepatic portal venous gas (HPVG) has rarely been reported, and the mortality rate has been very high. In most cases, surgical intervention was needed. Presently, abdominal computed tomography can be conveniently used to diagnose HPVG, which has various underlying causes and benign courses. We present the case of a patient with HPVG due to anastomosis leakage after a sigmoidectomy for diverticulitis; the patient was cured with conservative management.