Abdominal hypertension and venous insufficiency of lower limbs: is there a relationship?

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COD: 067-72 Categorie: ,

Domenico Parmeggiani, Marco Apperti, Vincenzo De Pascale, Nicola Avenia, Pasquale Ambrosino, Imma Madonna, Roberto Peltrini, Sarah Apperti, Adelmo Gubitosi, Umberto Parmeggiani

Ann. Ital. Chir., 2013 84: 67-72
aheadofprint 7 November 2012

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OBJECTIVE: The purpose of our study is to understand the compression, by subcutaneous fat in obese patients, who present
a chronic increase in abdominal pressure, and on the sapheno-femoral cross. Such increase would result in a chronic
venous insufficiency (CVI) of lower limbs and, if possible, it will be quantified also according to the posture.
MATERIAL AND METHODS: We studied two different groups of patients with CVI: obese and non-obese. The severity of
CVI was classified with the CEAP classification or by the standards of recent classifications. Abdominal pressure, by
means of Kron’s method, and anterior-sagittal diameter were measured in some of the non-obese patients (4 males and
4 females) and in all the obese patients. The diameter of the femoral vein of both groups of patients in supine, sitting
and standing positions was also measured.
RESULTS: We found a higher incidence of CEAP 5-6 classes in the obese group than in the non-obese one; we also saw
a higher incidence of classes 1-2 in the non-obese group than in the obese one. Moreover, Kron’s method showed a significant
difference in abdominal pressure in relation to the BMI and the increase in the femoral vein diameter appears
to be related to the weight and to the position.
DISCUSSION: It was clear that the clinical manifestations of CVI are more severe in obese than in non-obese patients.
Obesity in our study clearly acts with a continuous compressive action on the veins of the abdomen and thereby on the
femoral vein, further contributing to a retrograde flow. So we tried to quantify an entity that until now could only be
assumed.

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