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Exsanguinating hemorrhage from peripheral varicosities.

R L Wigle¹, G V Anderson

¹Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.

Annals of Emergency Medicine

|January 1, 1988

Summary

Spontaneous rupture of varicose veins can lead to fatal exsanguination, even without underlying clotting disorders. This rare but serious complication requires clinical awareness for prompt recognition and management.

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Area of Science:

Vascular Surgery
Emergency Medicine
Pathology

Background:

Varicose veins are a common vascular condition, typically associated with chronic venous insufficiency.
Complications of varicose veins usually involve superficial thrombophlebitis, skin changes, or bleeding from traumatized veins.
Spontaneous, non-traumatic rupture leading to exsanguination is an exceptionally rare event.

Observation:

A 48-year-old woman presented with cardiovascular collapse due to sudden, massive bleeding from an uninflamed, uninjured varicose vein.
Despite emergency resuscitation, the patient died from hemorrhagic shock.
Autopsy revealed no coagulopathy or cardiovascular disease, indicating the rupture was the primary event.

Findings:

The patient's death was attributed to exsanguination from a ruptured peripheral varicosity.
Pathological examination classified the lesion as an acute type, occurring in otherwise healthy skin.
This case highlights a previously underreported, life-threatening complication of varicose veins.

Implications:

Clinicians should consider spontaneous varicose vein rupture in cases of unexplained hemorrhagic shock, particularly in patients with known varicosities.
This emphasizes the need for vigilance regarding potentially severe complications of seemingly benign varicose veins.
Further investigation into the pathophysiology and risk factors for spontaneous rupture may be warranted.

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