[Deep venous malformations and Klippel-Trenaunay syndrome. Apropos of 5 cases].
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Biomedical subjects
Publications and source records attributed to J Coget.
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It is often difficult to confirm the diagnosis of post-phlebitic venous thrombosis. Doppler ultrasonography and plethysmography by venous occlusion can be performed in the consulting rooms to support the clinical diagnosis. These are comparative examinations which can be used to monitor the course of the disease. With a few examples, the authors demonstrate that Plethysmography by venous occlusion, in the initial phase, and venous doppler studies, in the second phase for localization of a possible thrombosis, are remarkable investigations in terms of their reproducibility, their safety and the fact that they can be readily repeated without the dangers associated with phlebography, which nevertheless still has an essential role.
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Local pigmentations can occur in the course of venous diseases and are said to be secondary to venous stasis and due to blood pigment. Most often, the pigment is haemosiderin and more rarely melenin pigments. Haemosiderin is a result of dermal biligenesis of extravasated red blood cells, the erythrodiapedesis being due to alterations in the vessel wall. Melanin pigments remain a mystery. Meaanoid may stimulate dermal melanocytes more than the true melanocytes of neural origin which have migrated to the epidermis. Above all, the problem is dominated by stasis and its microvascular and tissue consequences. The pigmentation is part of the "microangiopathy of stasis", as are the pigmentations occurring after therapeutic sclerosis.
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The angiodysplasias represent a "disease of the vasculo-connective tissue system", the cells of the primitive area vasculosa being simultaneously histoblastic and haemoblastic. This accounts for the many facets of the clinical picture and the nosology. The slightest deviation in ontogenetic organization involves one or more malformations which embryology unfolds in the course of the various stages of development, provided that the importance of vasculo-connective tissue correlations and hydraulic factors is never forgotten. The problem of nosological classification is very difficult ; many have attempted it, including the School of Nancy with Kissel and André, that of Milan with Puglionisi, that of Schobinger and Leu, that of J. Natali... it remains to classify the clinical picture presented in one or another list.