Fatal hemorrhage from peripheral varicose vein rupture

Abstract

Varix of the lower extremities is a common entity that eventually presents fatal outcome. Fatal massive bleeding due to rupture of a peripheral varicose vein is rare. The estimated incidence of these cases is 1/1000 autopsies. The case we present is unique among 26,054 autopsies performed in Milan from 1993 to 2020. It describes the investigations carried out in the suspicion of a non-natural event in an elderly woman. She was found dead at home with a large volume of blood near her feet that drained from the right leg. Pathological examination disclosed that the hemorrhage occurred by the rupture of a venous varix of the lower limb. Cases of fatal hemorrhage from peripheral variceal rupture are insidious and require proper characterization. The bloodstain pattern analysis, careful autopsy dissection by layers to demonstrate the rupture, and histologic examination of the lesion are the essential elements to find out the actual cause of death.

Near‐fatal bleeding due to ruptured peripheral varicose vein that developed after previous orthopedic surgery: A case report

“…Moreover, even small varicose veins can lead to massive bleeding and fatal outcomes. One case reported that a 91‐year‐old woman, who was self‐sufficient and living alone, took oral antiplatelet drugs, and died of ruptured varicose veins at home 4 . Herein, we present a case of severe hemorrhage from rupturing of peripheral varicose vein that were formed due to previous surgery.…”

A case of near-fatal bleeding due to ruptured peripheral varicose veins as a consequence of previous orthopedic surgery

“…Currently, patients receiving anticoagulants are increasing. One paper reported that a 91-year-old, self-su cient, and lonely woman who took oral antiplatelet drugs died of ruptured Varicose Veins at home [4]. Even small varicose veins can lead to massive bleeding and fatal outcomes.…”

Hemorrhage of Varicose Veins: An Indication for Sclerotherapy

“…2,3 Various contributing factors, such as geriatric skin fragility, use of anticoagulants and venous hyperpressure, consecutive to superficial venous insufficiency, deep venous insufficiency, or obstruction, further increase the risk of bleeding. 3,4 In this case report, we describe a case of recurrent bleeding associated with a varicose pearl nodule 1 on the dorsum of the right foot in a patient with superficial venous insufficiency.…”

“…1 Consequently, even minor injuries can trigger dramatic hemorrhage. 3,4 Immediate external compression often falls short in controlling bleeding, but elevation of the leg to heart level can rapidly reduce venous pressure and halt bleeding. 1 Surgical ligation lacks sustained efficacy and can delay wound healing.…”

“…1 Surgical ligation lacks sustained efficacy and can delay wound healing. 4,5 Conversely, sclerotherapy, especially when performed using foam formulations, offers a precise and safe intravascular approach, occluding varicose vessels effectively. 5 This minimally invasive method is especially valuable for superficial recurrent varices and complex cases, where surgery may not be ideal.…”