chapter  31
Case Treatment for varicose veins, leading to injury to deep veins (bilateral)
Pages 3

A 46 year old man underwent injection sclerotherapy to varicose veins in his left leg in 1973, followed by ligation to veins in 1978. In 1988, he had further problems with varicose veins in both legs and was referred to a consultant surgeon. He was seen in clinic and his name was placed on the waiting list for right high saphenous ligation, ligation of perforators in the right leg and ligation of recurrent perforators in the left leg. However, when admitted to hospital, it appears that the intention was to carry out bilateral high saphenous ligation with stripping. Surgery was performed by the consultant surgeon and his registrar, the operation note appearing to indicate that bilateral high saphenous ligation and stripping was attempted but, during the procedure, the femoral vein on both sides was damaged, requiring the interposition of an 8 mm PTFE (polytetralfluoroethylene) graft by the vascular surgeon on call. Post-operatively, the patient was commenced on heparin infusion and, subsequently, on warfarin. He was gradually mobilised and discharged home. He was subsequently reviewed in the out-patient clinic, where it was noted that he complained of persistent low back pain, for which he was referred to the rheumatologists. He also complained of pain in both groins, although no abnormality could be found, and he was finally discharged from surgical follow up. He appears subsequently to have seen an orthopaedic surgeon about pain in his hips, but has also been discharged from his care.