[Spontaneous varicose vein rupture of the lower limb]

Introduction: Spontaneous bleeding from rupture of the lower limb varicosity is a rare, usually shocking and sometimes lethal complication of venous disease. Objectives: Survey of frequency, pathology, location and possibilities of spontaneous varicose vein rupture and its therapy are the subjects of this study. Methods: Physical and ultrasound examinations were used to find pathologic conditions behind the rupture of the veins. Microsoft Office software was used for evaluating and processing our findings. This is a single-center retrospective study. Results: Spontenaous rupture of lower limb varicosity was found in 0.26% of our 25 000 patients. Based on the adult population of our country, this means that approximately 659.7 cases happen every year. Elderly and middle-aged people (mean: 56.8 ± 15.3 years) are subjects of spontaneous bleeding, more men (59.5%) than women. In terms of location of spontaneous rupture, it more frequently occurs at the ankle and foot (60.5%) than other regions of the lower limb. In each case, the size of the vein was about 1 mm in diameter and surprisingly not the very dilated, big veins. There is varicosity and chronic venous insufficiency in the background. For emergency treatment, aimed compression or injection sclerotherapy are better than haemostasis with sutures due to risk of developing an ulcer later on. Radical varicectomy is recommended for definite treatment. Conclusions: Earlier, small veins which are about 1 mm in diameter were regarded as cosmetic issues, but they can cause serious, sometimes lethal bleedings. Although this complication is rare, the venous disease is very common, so, colleagues who participate in emergency service must be prepared for this. For vascular specialists who deal with venous diseases for preventing or treating this complication, endovenous or classical surgery is recommended. Orv Hetil. 2024; 165(18): 711–716.