CLINICAL EXAMINATION LOST ART IN MEDICINE? : DIAGNOSTIC ROLE OF VENOUS COLLATERALS IN DETERMINING PROXIMAL VENOUS OBSTRUCTION.
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- Department of Vascular Surgery, Stanley Medical College, Chennai.
- Department of Vascular Surgery, Thanjavur Medical College, Thanjavur.
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Introduction: In this era of advanced medicine, the role of basic clinical examination is a forgotten art. Aim of the study is to determine the diagnostic role of visible venous collaterals determined by clinical examination in diagnosis of proximal venous obstruction. Material and Methods: This is an observational study done in 30 patients with venous leg ulcers in the past two years (2015-16). These patients were thoroughly examined clinically for visible venous collaterals. Confirmation of proximal venous obstruction is by means of CT or Conventional Venogram. Results: Out of 30 patients, 9 were found to have visible venous collaterals on clinical examination. 17 patients were confirmed to have proximal venous obstruction. All of these nine patients with venous collaterals found to have proximal venous obstruction. In our study, specificity and positive predictive value of the clinically visible venous collateral vein were found to be 100% each.With sensitivity and negative predictive values 52.94% and 61.9% respectively. Conclusion: Thus clinically visible venous collaterals in patients with venous leg ulcers are highly specific in diagnosing proximal venous obstruction. Emphasizing the fact that even in this era of advanced diagnostic modalities, basic clinical examination skills still holds good.
- Haimovici's Vascular Surgery, 6edition
- Hallet?s Comprehensive.Vascular.and.Endovascular.Surgery, 2nd
- Hood DB, Alexander JQ. Endovascular management of iliofemoral venous occlusive disease. Surg Clin North Am 2004;84:1381?96
- Kurstjens et al, Hemodynamic significance of collateral blood flow in chronic venous obstruction, Phlebology 2015;30:27-34
- Lea Thomas et al, Venous collaterals in external and common iliac vein obstruction, clin.radiol.(1967) 18, 403-411.
- Pagani et al, Computer Tomographic manifestations of abdominal and pelvic venous collaterals. Radiology 142:415-419, Feb 1982
- Ralph L. M. Kurstjens et al, Abdominal and pubic collateral veins as indicators of deep venous obstruction, J Vasc Surg: Venous and Lym Dis 2016;4:426-33.
- Rutherford?s vascular surgery, volume-1, 8th
- Wesley S.Moore?s Vascular and Endovascular surgery, 8th edition
- Wittens et al, Abdominal wall venous collaterals : the latent clinical sign for central venous obstruction,Circulation.2010;122:2089-2090.
[Thulasikumar. G, Elancheralathan. K, Deepan kumar. B, Ashok kumar. D, Shanmughavelayutham. C and Lakshmi dharan. M. (2017); CLINICAL EXAMINATION LOST ART IN MEDICINE? : DIAGNOSTIC ROLE OF VENOUS COLLATERALS IN DETERMINING PROXIMAL VENOUS OBSTRUCTION. Int. J. of Adv. Res. 5 (Apr). 1029-1034] (ISSN 2320-5407). www.journalijar.com
Department of Vascular Surgery, Stanley Medical College, Chennai