What is the significance of swelling in the physical exam of venous insufficiency?

Updated: Oct 22, 2018
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Swelling may result from acute venous obstruction (as in deep venous thrombosis [DVT]) or deep or superficial venous reflux. Alternatively, swelling may be completely unrelated to the venous system. Lower-extremity pitting edema is common in patients with venous insufficiency. Hepatic insufficiency, renal failure, cardiac decompensation, infection, trauma, and environmental effects can also cause lower-extremity pitting edema that may be indistinguishable from edema due to venous obstruction or venous insufficiency.

Lymphatic edema may be a sign of primary lymphatic outflow obstruction, or it may be secondary to the overproduction of lymph as a result of severe venous hypertension (a so-called venolymphatic syndrome).

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