Purpose: to assess the incidence of lymph node varices and their relation to lower limb edema in patients with and without surgically treated varicose disease.
Methods and Materials: 8 - 13 MHz ultrasound of the groin was performed, over 60 months, in 182 patients with former operation of lower limb varices and in 164 patients with untreated lower limb varices. Intranodal varices when present, were graded as: grade 1 - node sinus still visible; grade 2 - no node sinus visible. Presence and grade of nodal varices was plotted against the presence of limb edema.
Results: incidence of edema was 36,3% in the operated group and 31,1% in the untreated one (p= ns).The incidence of lymph node varices - edema and no edema, was 63,3% and 12,1% in the operated group (p<0,01) and respectively 35,2% and 11,5% (p< 0,05) in the untreated group. In the treated group, two patients without edema presented grade 2 dilatation; this was encountered in 15 patients (22,7%) in the edema group. For the untreated group, there was no grade 2 dilatation in the nonedema subgroup and seven patients (13,7%) showed grade 2 nodal varices in the edema group. Transnodal veins were only observed in the operated group.
Conclusions: The results infer a high prevalence of groin intranodal venous varices in patients with lower limb venous varices and edema. Transnodal veins have, to the best of our knowledge, not been previously described. This finding may represent a compensatory mechanism or an indirect cause of edema.
