A Rare Case of Recurrent Lower Extremity Ulcer

Area of Science:

• Vascular Surgery
• Hepatology
• Dermatology

Background:

• Venous leg ulcers stem from chronic venous disorder and venous hypertension, presenting complex treatment challenges.
• Standard treatments include medication, compression therapy, and surgery, with varying success rates.
• Budd-Chiari syndrome, a rare condition causing portal and/or inferior vena cava hypertension, requires specialized management.

Observation:

• An elderly female patient presented with recurrent, poorly healing lower extremity ulcers despite prolonged conventional treatment and skin grafting.
• Further investigation revealed the patient had Budd-Chiari syndrome.
• The patient's venous leg ulcers were refractory to standard treatments.

Findings:

• The patient's Budd-Chiari syndrome involved inferior vena cava stenosis.
• Multidisciplinary treatment focused on resolving the inferior vena cava stenosis.
• Surgical intervention to address venous hypertension and wound management led to ulcer healing.

Implications:

• This case highlights the importance of investigating rare underlying conditions like Budd-Chiari syndrome in refractory venous leg ulcers.
• Successful management of Budd-Chiari syndrome can lead to the resolution of severe venous leg ulceration.
• Integrated, multidisciplinary approaches are crucial for complex vascular and dermatological conditions.