Varicose veins can be fatal

A 66-year-old woman was found dead by her neighbor in her house lying in a pool of blood. Tissues soaked with crumpled blood were found beside her body, and smears and small blood pools were found throughout the house.

The woman lives alone and her medical history is unknown. During autopsy, the skin on her left thigh showed severe edema, reddish-brown discoloration and induration compatible with chronic venous insufficiency (CVI). This happens when the veins in the legs do not allow blood to flow back into the heart.

A 7 mm skin ulcer was found on her left thigh. These have been strong signs of venous insufficiency and stasis dermatitis (skin changes seen in people with varicose veins) for many years.

Upon dissection, the surrounding skin was very hard and the edges of the ulcer were reddish and folded, but the base of the ulcer was red and there was evidence of continuous superficial veins. No obvious traumatic lesions such as abrasions or bumps were observed.

CVI develops when venous pressure rises and blood return is impaired by several mechanisms.

The first is due to valve dysfunction or dysfunction (these valves open and close to control blood flow in the veins), which prevents venous insufficiency and the formation of varicose veins.

The second is due to venous obstruction, or a combination of both. These factors are exacerbated by muscle pump dysfunction (when the calf muscles behind the legs are unable to fully contract and thus pump blood back to the heart).

These two mechanisms help cause venous hypertension. This occurs when the pressure in the veins rises due to the retention of blood secondary to valve defects. Calf muscle pump dysfunction, especially when standing or walking.

If left untreated, this can lead to rupture of veins. It is the changes in the microcirculation that contribute to the macrocirculatory hemodynamic disorder. Unabated varicose veins are changes in the skin with hyperpigmentation, subcutaneous tissue fibrosis called “lipodermatosclerosis” (distal 3 minutes of the legs secondary to skin tightening as a result of scarring under the skin) One of the stenosis), and the final ulceration, and the formation that can cause large varicose veins.

As in this particular case, death characteristics from massive bleeding from ruptured varicose veins secondary to chronic venous insufficiency have been reported. They include related features such as old age, social isolation, possible underlying medical conditions (eg, motor restriction, dementia), mild traumatic bleeding, alcohol intake and anticoagulants. ..

Another important risk factor is hardening of the vessel wall, which can lead to spontaneous bleeding. Diseases that coexist as a predisposing factor for death, such as ischemic heart disease, have been reported.

Interestingly, in this case, the presence of cirrhosis (based on autopsy) seemed to contribute to the fatal consequences. Chronic impairment of the liver’s ability to produce blood proteins to stop bleeding prevented the formation of blood clots to control massive blood loss, making women more susceptible to severe bleeding and accelerating death.

In the case of death from varicose vein rupture, the victims’ failure to provide appropriate immediate medical care to themselves (eg, direct pressure application or elevated bleeding limbs) contributed to their death. It is worth mentioning that there is a possibility.

The victim in this case tried to give himself first aid as blood-stained tissue was found around her. The results of her liver pathology (cirrhosis) showed exaggerated bleeding. This quickly lost consciousness and hastened death.

A total of 66 cases have been reported since the phenomenon was first discovered in 1973. The youngest person to die from a fatal varicose vein rupture is reported to be a 29-year-old man. A store lying in the blood.

Varicose veins are a chronic clinical symptom. Varicose veins affect one-quarter to one-third of all adults, according to a review of patients in Western countries. Although they are usually benign, severe varicose veins can cause major complications such as edema, dermatitis, lipodermatosclerosis, ulceration, and severe bleeding.

The ulcer is due to a decrease in the sense of protection of the lower limbs. Increased damage (at a minimum) associated with these areas can also lead to delayed healing of these ulcers and an increase in ulcers with frequent recurrence, especially in bone ridges.

On the other hand, if a person with varicose veins takes other factors such as anticoagulants, alcohol, and sedatives, bleeding can be exacerbated.

When serious bleeding occurs, it simulates arterial bleeding, represents first aid, and can be fatal if not treated immediately. Varicose veins are a benign clinical pathology, but they hide the risk of rupture if left untreated. Subsequent venous bleeding can be severely concentrated and can quickly lead to loss of consciousness and death. Being aware of the risk of major bleeding may increase the need for prophylactic treatment.

Whenever a dermatologist and therapist treat a patient for varicose veins or other medical conditions that may exacerbate the varicose veins, the possibility of harmful interactions of the pathological entity leading to fatal bleeding of the varicose veins It should be kept in mind that gender should always be considered.

The good news is that there are ways to prevent it from developing and prevent complications.

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