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The purpose of this paper is to present the case of a 35 years old healthy male suffering from acute, bilateral uveitis with periphlebitis which despite broad ophthalmic and internal diagnosis remained of unknown origin. Despite anti-inflammatory treatment with acyclovir, ciprofloxacin and Encorton remission of inflammation was not achieved. Due to the failure of steroid treatment the decision of immunosuppressive therapy with Rapamycine and Endoxan was made. New therapeutic regimen caused the remission of inflammation and preserved patient's useful visual acuity.

Background: Since the description of the "multiple evanescent white dot syndrome" (MEWDS) by Jampol et al, choroiditis has been in the focus of interest. But the classical type of MEWDS was an exceptional case in clinical routine., Case Report: A 48-year-old female presented to our hospital with a sudden unilateral visual acuity decrease and an extension of the blind spot. Ophthalmoscopy and fluorescein angiography revealed typical multiple grey-white chorioretinal patches of the same stage with lesion areas of about 100 - 200 microm compatible with the diagnose of MEWDS. Although visual acuity increased continuously the patient developed a classical choroidal neovascularization within 4 weeks. She was treated with PDT and visual acuity as well as the ophthalmoscopic diagnosis remained stable., Conclusion: In spite of visual improvement in MEWDS, regular control is recommended. In addition we propose to consider the diagnosis of MEWDS if an enlargement of the blind spot and CNV without lesions of the retinal pigment epithelium are diagnosed.

Purpose: To report cerebral venous thrombosis as a complication of intravenous corticosteroid treatment in a patient with multiple sclerosis., Method: A case report. A 44-year-old woman with a previous diagnosis of multiple sclerosis presented with panuveitis and retinal perivasculitis. Intravenous pulse corticosteroid therapy was given for three days., Results: The panuveitis and retinal periphlebitis began to resolve within one week; however, ten days after the last corticosteroid dose, the patient was hospitalized with the diagnosis of cerebral venous thrombosis., Conclusion: Although intravenous corticosteroid treatment for uveitis associated with multiple sclerosis can be very helpful, the patient should be monitored closely for systemic side effects.

Methods: From January to December 2001, 89 patients with multiple sclerosis (MS) were treated in our hospital; 24 of them were diagnosed for the first time. All patients underwent a complete ophthalmologic examination including a three-mirror contact lens examination when photopsias were found or the disease was diagnosed primarily., Results: Two patients showed vitreoretinal tractions with signs of periphlebitis before clinical-neurological manifestation of multiple sclerosis. The third patient, in whom the disease had been known for years, showed distinct neovascularizations, vasculitis, and recurrent vitreous hemorrhages. High-dose steroid therapy resulted in stabilization of the retinal situation in one patient, but the tractions remained unchanged. Additional laser coagulation in the second patient achieved stabilization and reduction of the tractions. A pars plana vitrectomy led to stabilization of the retinal proliferation in the third patient., Conclusions: The vitreoretinal traction syndrome is associated with MS and can precede its clinical-neurological manifestation. The good results after argon laser coagulation and vitreoretinal surgery suggest a vascular pathogenesis of these tractions.

This paper describes the first results of endovasal laser obliteration of the greater sephenous vein in two patient groups (n=40) math varicosis. In 15 cases (control group), laser obliteration was employed during routine operation as an alternative to phlebectomy according to Babcock following crossectomy. In 25 patients (the main group), operation was performed without ligation of the saphenofemoral anastomosis. After puncture and catheterization according to Seldinger the greater saphenous vein was exposed to thermal action over the length from the osteal valve to the upper third of the leg. The follow up of the patients amounted to 12 months. The results obtained in the main patient group seem most interesting. Stable elimination of truncal varicosis could be attained in more than 90% of cases, which was associated with quick medicosocial rehabilitation, the minimal number of complications and an excellent cosmetic effect.

Purpose: To report the unusual association between severe retinal periphlebitis resembling frosted branch angiitis and nonperfused central retinal vein occlusion (CRVO)., Methods: Observational case reports., Results: Patient 1 was a 28-year-old man who presented with extensive sheathing involving all retinal veins in one eye followed by nonperfused CRVO. Twenty-seven months after initial presentation, he developed perfused CRVO in the other eye followed by periphlebitis that progressed into nonperfused CRVO. Patient 2 was a 47-year-old man who presented with unilateral severe retinal periphlebitis associated with nonperfused CRVO. Despite systemic administration of corticosteroid therapy, rubeosis iridis developed in both patients and neovascular glaucoma developed in Patient 1 despite full panretinal photocoagulation. Extensive systemic workup and coagulation studies were unremarkable except for the presence of antiphospholipid antibodies in both patients and elevated plasma homocysteine level in Patient 2., Conclusions: Severe retinal periphlebitis complicated by nonperfused CRVO is associated with poor visual outcome despite appropriate medical and surgical treatment.

Objective: To compare the efficacy of two available preparations (heparin, 10 U/mL, 1 mL, vs. normal saline, 1 mL) used for maintaining patency in peripheral intravenous (IV) locks during pregnancy., Design: Prospective, randomized, and double-blind. Eligible patients who were to receive a peripheral intermittent IV lock were randomly assigned to receive either heparin flushes or normal saline flushes for IV lock maintenance. IV locks were flushed after each medication administration, or at least every 24 hours, with the assigned blinded flush solution. Intermittent IV lock sites were also evaluated every 12 hours for the development of phlebitis., Setting: A large academic medical center in the Midwest that has both community-based and regional-referral obstetric practices with more than 2,000 deliveries per year., Participants: A convenience sample included 73 hospitalized pregnant women who were between 24 and 42 weeks gestation. Exclusions from the study were women with significant abnormalities in the fetal heart tracing on admission, cervical dilation > 4 cm, presence of hypersensitivity to heparin, presence of clotting abnormalities, and anticoagulation therapy (including low-dose aspirin)., Results: Data indicate there were no statistically significant differences in IV lock patency nor in phlebitis between heparin or normal saline flushes., Conclusions: This study provides support that both normal saline and heparin in the doses studied may be equally effective in the maintenance of peripheral IV locks. Due to small sample size, additional studies are needed to determine optimal therapy over time.

History and Clinical Findings: A 30-year-old male was transferred to the intensive care unit with worsening sepsis of unknown origin and a known history of Crohn's disease. The patient presented with a five-day history of nausea, fever, and serous diarrhea. Clinical examination of the abdomen was unremarkable except for mild epigastric pain on palpation., Investigations: Computed tomography (CT) of the abdomen revealed gas within the intrahepatic branches of the portal venous system, thickening of the wall of the neoterminal ileum, and mild ascites. In addition, ultrasonography showed acute thrombosis of the portal vein and the superior mesenteric vein. No wall perfusion was seen in either the neoterminal ileum or the ascending colon on color Doppler sonography., Diagnosis, Treatment and Course: Based on the combination of portal vein thrombosis along with venous gas in the portal venous system and absence of intestinal perfusion, the diagnosis of pylephlebitis with septic shock was suspected and a laparotomy was performed. Intraoperative exploration revealed phlegmonous terminal ileitis, a significant amount of cloudy fluid, and thrombosis of the mesenteric vein. A right-sided hemicolectomy with ileotransversostomy was performed. Histologic examination confirmed Crohn's disease that was associated with vasculitis and, in particular, with thrombophlebitis and subsequent transmural bowel necrosis. Antibiotic and anticoagulation therapy was resumed without further complications., Conclusion: In the differential diagnosis of sepsis, especially in combination with abdominal pain or gas in the portal venous system, pylephlebitis should be taken into account. Because of the high mortality, immediate further diagnostic testing and appropriate therapy of this rare diagnosis are necessary.

Infections with Bacteroides species have been noted to occur in association with cases of thrombophlebitis. This association has led to the speculation that the microorganisms themselves may contribute to the pathogenesis of thrombus formation through elaborated enzymes, including heparinases, or by interactions between the clotting cascade and the unique structure of the Bacteroides lipopolysaccharide. Anti-phospholipid antibodies have been linked with hypercoagulable states and thrombus formation. Although a number of infections have been associated with the transient production of anti-cardiolipin antibodies, the effect the antibodies may have in contributing to thrombus formation is not well understood. The occurrence of Bacteroides species infection with transient anti-cardiolipin antibody has not been previously reported.

This study was planned and applied in 2 stages. Stage I was applied to determine the knowledge of nurses working in the internal medicine, surgery, obstetrics and gynecology, pediatrics, and other services in Celal Bayar University Hospital about using intravenous catheter and intravenous fluid treatment, and the symptoms and treatment procedure for phlebitis. Stage II consisted of observation of all patients who had intravenous catheters for symptoms of phlebitis for 5 days and the interventions the nurses used for the patients who had phlebitis. In stage I, questionnaires were used to determine the knowledge of the nurses; in stage II, 2 investigators observed the patients. Results were evaluated using SPSS software with chi(2) statistical analysis. Nurses were found to have high knowledge levels, but their practices were not suitable to their knowledge levels. Of the patients who participated in the study, 67.24% showed symptoms of phlebitis. We found that there was a significant relationship (P <.05) between the selection of the vein and the occurrence of phlebitis in patients who had an intravenous catheter. We also found that the relationships between the age groups of the patients and phlebitis and the relationships between the diagnosis and phlebitis were statistically significant (P <.05).

Two patients with a grenade-splinter injury with clinical symptoms of a thrombophlebitis and periphlebitis are presented. Unexpectedly, the supposed thrombus proved to be metallic fragments. Both patients recalled to be wounded in the second world war in 1944/1945 by grenades. The splinters were not extracted. Both patients experienced more than 5 decades without any symptoms. As an after-effect caused by movement of the splinters, significant superficial inflammation could be seen now.

This study investigated the curative effects of notoginseny cream versus Hirudoid cream in the treatment of postinfusion phlebitis. Sixty-five patients who received peripheral infusion therapy during a 20-month period and had developed phlebitis were divided randomly into two groups. Group A was treated with notoginseny cream, a topical Chinese medicine developed and produced by the pharmacological department of The Second Affiliated Hospital of Sun Yat-Sen University. Group B was treated with heparinoid cream (Hirudoid, a commercial product from Germany). Significantly fewer applications of notoginseny cream were required to bring about the disappearance of signs and symptoms of phlebitis in the group A patients as compared with the group B patients for the same effect. The actual time of disappearance of the signs and symptoms of phlebitis also were significantly shorter in patients treated with notoginseny cream than with heparinoid cream.

Objective: To review the epidemiology, clinical presentation, pathogenesis, imaging, differential diagnosis, complications, and treatment of popliteal cysts., Methods: References were taken from MEDLINE from 1985 to 1998 under the subject "Popliteal Cyst" with subheadings of Radiography, Ultrasonography, and Radionuclide Imaging. Other pertinent references were used. Childhood cysts were excluded., Results: Depending on the studied population and the imaging technique, 5% to 32% of knee problems may have these cysts, with 2 age-incidence peaks of 4 to 7 years and 35 to 70 years. In older patients there is usually coexistent joint pathology. Symptoms may arise in the popliteal fossa from the cyst itself or be dominated by knee pain from coexisting knee pathology. Many cysts are asymptomatic. Physical examination will miss one half of these cysts. Pathogenesis depends on the connection between the joint and bursa, with a valvelike effect allowing passage of fluid from the joint into the bursa with subsequent distention producing these cysts. Some bursae have no such joint-bursal communication, and the cysts arise primarily as bursitis of the gastrocnemio-semimembranosus bursa. Imaging is performed by plain x-ray, ultrasound, arthrography, computerized axial tomography, magnetic resonance imaging, or nuclear scan; sonography is the method of choice. Complicated cysts with extension or rupture into the calf mimic phlebitis, an important differential diagnosis. Asymptomatic cysts found incidentally need no treatment; most symptomatic cysts respond to intra-articular corticosteroid injections. Surgical excision is rarely necessary., Conclusions and Relevance: Popliteal cysts are fairly common, may not be found on physical examination, require imaging (preferably sonography) to be identified, mimic phlebitis when extending into the calf, and often respond to intra-articular steroid or, rarely, surgical resection., (Copyright 2001 by W.B. Saunders Company)

Deep venous thrombosis (DVT) of upper limbs is extremely rare. DVT related to physical stress is a less known form. The purpose of this study was to outline the clinical pattern and laboratory features as well as the clinical course and outcome of this disease. The authors report 5 documented cases of upper limb DVT related to physical stress: 4 patients were hand workers and 1 was a young athletic man. None of the patients developed pulmonary embolism. Two patients had late sequelae. Treatment is based on prompt and early anticoagulation. Prevention can be achieved by contention, active physiotherapy and professional rehabilitation.

Objective: Funisitis, the inflammation of the umbilical cord determined by histologic examination of the placenta, is evidence of a fetal inflammatory response. The inflammatory process may involve the umbilical vein (phlebitis) and one or both umbilical arteries (arteritis) and extend into the Wharton's jelly. This study was conducted to examine whether the pattern of inflammation of the umbilical cord correlates with a biochemical marker of systemic fetal inflammation (umbilical cord plasma interleukin-6) and an adverse neonatal outcome., Study Design: This cohort study included 636 cases of preterm delivery (<36 weeks) with or without inflammation of the umbilical cord. Umbilical cord blood was collected at the time of delivery. The aim of pathologic examination was to characterize the extent of umbilical cord inflammation and the involvement of the vein (phlebitis), the involvement of one or both arteries (arteritis), and the presence of inflammation of the Wharton's jelly. Umbilical cord plasma interleukin-6 concentrations were assayed by a sensitive and specific immunoassay., Results: Neonates with umbilical arteritis had a significantly higher median concentration of cord plasma interleukin-6 (median, 111 pg/mL; range, 0.1-19,230 pg/mL) than those without umbilical arteritis (median, 22.5 pg/mL; range, 0.9-511.6 pg/mL; P <.05). Also, severe neonatal morbidity occurred more frequently in infants with arteritis than in those without arteritis (74% vs 50%; P <.05). And finally, the most severe form of inflammation, which involves both arteries, vein, and Wharton's jelly, was associated with the highest median concentration of plasma interleukin-6 observed in this study (median, 182.6 pg/mL; range, 0.1-7,400 pg/mL), whereas inflammation limited to the vein (phlebitis) was associated with a lower concentration of cord plasma interleukin-6 (median, 29.1 pg/mL; range, 0.9-511.6 pg/mL; P <.05)., Conclusion: Neonates whose placenta demonstrates umbilical arteritis have higher concentrations of umbilical cord plasma interleukin-6 and higher rates of adverse outcome than those without umbilical arteritis.

Brucellosis is hyperendemic in Saudi Arabia where, despite rapid urbanisation, a large segment of the population has a nomadic background and clings to cultural traditions such as the drinking of raw milk. We report here an unusual complication of brucellosis in a microbiology technologist. A 41-year-old male presented with an 8-day history of right ankle pain which, over a 3-day period, extended up to his calf where swelling and tightness developed. The leg symptomatology occurred on a background of fever, seats and rigors. X-ray of the limb was normal but a venogram revealed thrombosis of the deep veins of the right calf. Although his blood culture was negative, he developed high brucella antibody titres. Treatment with anticoagulants combined with a course of doxycycline and rifampin produced a full recovery., (Copyright 2001 The British Infection Society.)

Purpose: To report three cases of presumed Eales' disease with neurologic lesions., Methods: Case reports, systemic and neurologic evaluation, and magnetic resonance imaging., Results: All three patients were young men who had seizures in the past; two had migrainous headache. Magnetic resonance imaging showed putaminal infarct in two cases and edema in the white matter of temporal cortex was noticed in one case. Clinical features in all these patients were suggestive of Eales' disease., Conclusion: Ischemic infarction of the brain can be seen in clinically suspected cases of Eales' disease.

A case of focal myositis in a healthy 68-year-old woman is described. The patient was admitted for evaluation of a painful soft-tissue mass localised on the medial side of the left thigh, initially misdiagnosed as thrombophlebitis of the v. saphena magna. Laboratory data were normal, in particular sedimentation rate and muscle enzyme levels. After exclusion of venous thrombosis, the mass localised in the left m. gracilis was surgically removed. Histologic examination of the biopsy specimen showed muscle cell necrosis and severe inflammation, with lymphocytic infiltration leading to the diagnosis of focal myositis. This is a rare benign inflammatory pseudotumour of skeletal muscle. The aetiology and pathogenesis of the disease remain unclear. It is most commonly seen in the lower extremities and may mimic thrombophlebitis or soft-tissue neoplasm. Ultrasound and magnetic-resonance scans are helpful, but definitive diagnosis is obtained only by histology. Because recurrent lesions in other skeletal muscles are possible, and a third of patients develop polymyositis, a follow-up of several years is recommended.

A previous history of deep venous thrombosis (DVT) must be carefully evaluated in every patient affected by chronic venous insufficiency (CVI); the assessment of deep venous system patency is the goal of preoperative diagnosis. Air plethysmography examination allows an outpatient noninvasive testing of calf pump function and deep venous outflow. The authors report the results of a study on 37 patients (40 limbs) with a previous history of DVT, suffering from CVI; in 18 limbs air plethysmography showed a marked increase of calf volume on test exercise, suggesting residual venous obstruction. The authors believe that air plethysmography examination is mandatory before operation in patients with a previous history of DVT.

Patient: A 44-year-old woman has a history of multiple sclerosis since 20 years. Besides recurrent numbness she had many instances of optic nerve neuritis which has led to a pronounced optic atrophy on her left eye. Additionally, she has developed recurrent iridocyclitis on her right eye. This was the reason why she was referred to our outpatient department for evaluation. Ophthalmic examination revealed an iridocyclitis associated with a multifocal retinal periphlebitis and severe cystoid macular edema in her right eye., Conclusion: Patients with multiple sclerosis develop in approximately 30% of cases retinal periphlebitis which may rarely be associated with anterior uveitis or cystoid macular edema as observed in our patient.

Objective: To investigate patients with acute optic neuritis (ON) for changes of the retinal veins., Material and Methods: Seventy-six patients with acute ON were extensively neuro-ophthalmologically examined., Results: Multiple sclerosis (MS) was found in 41 patients of whom 1 had periphlebitis retinae (PR) and 2 had venous sheathing (VS). Probable MS was found in 15 patients without prior symptoms of MS. One had PR and VS, and 2 had VS. Twenty patients had mono-symptomatic ON, none had retinal changes., Conclusion: Changes of the retinal veins should alert the clinician to a probable diagnosis of MS. ON appears frequently as the initial symptom of MS. Our observation of VS in these patients suggest that clinically silent retinal disease activity had occurred prior to the ON.

Background and Purpose: Tortuous, engorged veins can be identified on the venous phase of the brain circulation in patients with venous congestion related to an intracranial dural arteriovenous fistula (DAVF). The term pseudophlebitic pattern (PPP) has been used to describe this finding. The purpose of this study was to determine the prevalence of PPP in patients with intracranial DAVF and to analyze the relationship of this sign to presentation, location of the fistula, presence of retrograde leptomeningeal venous drainage, and MR findings., Methods: We retrospectively reviewed the charts and imaging findings of 130 patients with intracranial DAVF. In 122 patients the venous phase of the brain circulation was adequately assessed. The PPP was graded as mild, moderate, or severe., Results: PPP was found in 51 patients (42%). Thirty-two (73%) of the 44 patients who had a hemorrhage, neurologic deficit, or seizure had PPP as compared with 16 (21%) of the 75 who had a bruit or orbital signs. The three patients with either congestive heart failure or increasing head circumference had PPP. Fourteen (88%) of the 16 who had fistula of the superior sagittal sinus, straight sinus, or superior petrosal sinus had PPP. PPP was seen in 46 (81%) of 57 patients who had retrograde leptomeningeal venous drainage and in five (8%) of the 65 who had only sinosal drainage. Fourteen (88%) of the 16 who had white matter T2 hyperintensity on MR images had severe PPP., Conclusion: The PPP reflects venous congestion and is associated with an aggressive presentation with or without retrograde leptomeningeal venous drainage. PPP may be a useful prognostic indicator and should be considered in treatment decisions.

This article, the first of two-parts, addresses the growing problem of intravenous-related phlebitis in hospitalized patients, and the resultant personal and financial costs to both patient and hospital. Literature on the various types of phlebitis, the factors that increase the patient's risk of developing phlebitis, clinical indicators and severity grading scales, and the complications of phlebitis are examined. Awareness of such factors is considered instrumental in minimizing the incidence of intravenous-related phlebitis. The second article in this series will present a study of 90 patients from a large teaching hospital, which was conducted to determine the incidence and severity of intravenous-related phlebitis, risk factors, associated complications, and the related length of hospital stay. The implications of the results for current and future nursing care of patients receiving i.v. therapy will be discussed, and recommendations for safe practice will be made.

Patency of the vascular access device and the vein that houses the device is critical for the successful delivery of infusion therapy. Loss of catheter patency comes from decisions made during device insertion and from methods used for infusion, flushing, dressing, and removal. Loss of vein patency comes from insertion techniques, patient activity, anatomic and physiologic reasons, and the primary disease or underlying chronic diseases. This review provides the latest information on causes, reported incidences, management, and prevention of catheter and vein patency problems frequently encountered in all clinical settings.

Background: More than 60 years ago, Christian described a panniculitis that was later termed Weber-Christian disease., Objective: The purpose of this study was to investigate whether this is a specific disease or a nonspecific disease that embraces several specific conditions., Methods: We studied 30 cases diagnosed as Weber-Christian panniculitis and found it possible to make a more specific diagnosis., Results: In 12 patients, findings were compatible with erythema nodosum. Six patients had phlebitis or postphlebitic syndrome. Factitial panniculitis was diagnosed in five patients, and trauma had a role in the conditions of another three patients. Cytophagic panniculitis, lymphoma, and leukemia were recognized in one patient each. The lesion was lobular in almost all cases, and the presence of lipophagia was noted in 19 biopsy specimens. Granulomatous, neutrophilic, and lymphocytic pathologic changes were present in nine, eight, and eight tissue specimens, respectively., Conclusion: The recognition of distinct disease patterns of fat lesions as fat necrosis with pancreatic disease, alpha1-antitrypsin panniculitis, lupus and connective tissue disease panniculitis, involution lipoatrophy, lipomembranous panniculitis, factitial panniculitis syndromes, calcification panniculitis, lipophagic lipoatrophy, and cytophagic panniculitis has lessened the need for a less specific panniculitis category. All these diseases have been reported in the literature as "Weber-Christian disease." Because separate and distinct forms of fat lesions have been described, we believe that the eponym should be abandoned and that more specific diagnoses should be made on the basis of pathogenesis or cause.

The purpose of this article is to describe a clinical finding not previously reported in lens-induced uveitis. An 86-year-old woman was seen by the authors 2 weeks after she had undergone phacoemulsification surgery complicated by retained lens material. A pars plana vitrectomy was indicated. Intraoperatively, retinal arteritis and phlebitis were documented in the retina immediately adjacent to the lens material. This resolved after removal of the material by vitrectomy. This previously unreported finding demonstrates the focal inflammatory effect of the retained lens material on the retinal vasculature.

Background: Pylephlebitis may complicate any intra-abdominal infection and carries a high mortality rate. Acute cases are usually anticoagulated to prevent thrombus extension and enteric ischemia; however, the role of anticoagulation has not been clearly defined., Methods: Over a 3-year period, pylephlebitis was diagnosed in 44 patients with portal vein thrombosis on computed tomography scan with fever, leukocytosis, and/or positive blood cultures. The charts were reviewed for etiology, extent of venous thrombosis, and method and results of treatment., Results: Eighteen patients were hypercoagulable, due to clotting factor deficiencies (6), malignancy (8), or AIDS (4). Fifteen patients had mesenteric vein involvement. Thirty-two patients were not anticoagulated, and 5 died (3 with hypercoagulable states and 2 with normal clotting function). Twelve patients were anticoagulated, and none developed subsequent bowel infarction or died., Conclusion: Patients with pylephlebitis and a hypercoagulable state due to neoplasms or clotting factor deficiencies should be anticoagulated. Patients with normal clotting function and mesenteric vein involvement may also benefit. We believe anticoagulation in patients with thrombus isolated to the portal vein and normal clotting function may be unnecessary.

Pylephlebitis or septic thrombophlebitis of the portal vein, a precursor of hepatic abscesses, is an extremely rare and frequently fatal complication of diverticulitis. The following report describes a patient presenting with pylephlebitis and complicated diverticulitis. Diagnosis was confirmed by computed tomography. The patient had a favorable outcome with medical and surgical therapy, prompting us to evaluate historical treatment of pylephlebitis.

Eales' disease is common in India and the Middle East, but its neurologic manifestations are rare. The authors report a young man with recurrent vitreous hemorrhage and acute amnestic confusional state who subsequently developed myelopathy. Eales' disease should be considered in the differential diagnosis of stroke in a young patient.

The authors studied 200 consecutive outpatients with symptoms due to venous disease of the lower limbs. All the patients underwent anamnestic, clinical and instrumental evaluation (c.w. Doppler velocimetry and strain-gauge plethysmography). The results of this study showed that some anamnestic and clinical data are significantly related to venous disease detected by instrumental techniques. The superficial and deep vein hypertension were, instead, correlated to oral contraceptive use.

We describe a 35-year-old woman with colonic phlebitis of unknown origin accompanied by effusion of serum protein into the peritoneal cavity. Abdominal ultrasonography and computed tomography showed massive ascites and edematous wall thickness of the colon. Laboratory examination of the peritoneal fluid showed a high concentration of protein, probably due to nonselective efflux of serum protein. The main histopathological finding was extensive edema of the submucosa with vasculitis in the colon. This kind of phlebitis with massive ascites, but without systemic involvement, and with the ascitic fluid almost identical to the serum protein level, has not been reported previously.

Mycotic aneurysm of the posterior tibial artery and pseudophlebitis: role of color Doppler sonography A case of a 78-year-old male patient presenting with endocarditis caused by Streptococcus bovis and pseudophlebitis of the left lower limb is described. Color Doppler sonography ruled out thrombophlebitis and showed a large pulsatile mass of the posterior compartment of the leg due to a mycotic aneurysm of the posterior tibial artery. This aneurysm was confirmed by angiography and treated by surgery. The important role of color Doppler sonography for the diagnosis of this particular case is emphasized.

A case of Mondor's disease is described. They remark etiopathogenesis and clinical signs of this rare disease that affects thoraco-epigastric vein or one of its confluents. They point to the benignity of the disease that tends to evolve to a spontaneous healing in a few weeks. Authors confirm the advisability of performing appropriate exams to exclude malignancies of the breast.

The acute stage of venous thrombosis is characterized by an inflammatory process, therefore the term phlebitis is often erroneously equated with venous thrombosis. In most cases, however, the inflammatory reaction or phlebitis is a secondary phenomenon, associated with the process of fibrinolysis and phlebitis as a primary cause is rare. Postthrombotic sequelae such as edema, varicose veins and ulcers usually are late complications and can take a long time to develop. The primary cause of the postthrombotic syndrome is related to an injured venous wall, including damaged valves or stenosis due to incomplete recanalisation. The amount of damage is dependent on the extent of the primary thrombosis and the degree and rapidity of thrombolysis. When postthrombotic changes are suspected, functional evaluation can be performed with ambulatory venous pressure measurement in a foot vein or with the aid of non-invasive methods such as volumetry.

A 30-year-old woman developed bilateral acute vision loss without any systemic symptoms. There was diffuse retinal edema and thick perivenous sheathing with moderate vitreous inflammation. Fluorescein angiography showed late staining and dye leakage from diseased vessels. Oral corticosteroid treatment stabilized the visual acuity and fundus of the left eye but did not halt the progression to total fibrosis in the right eye.

Venous compromise as a cause of ischemic colitis and enteritis is infrequent. Enterocolic lymphocytic phlebitis, a rare cause of such compromise, to our knowledge has been reported in only three patients. We describe a patient with this condition who had hematochezia and a cecal mass that was mistaken endoscopically and radiologically for carcinoma and required resection. The mass, which was ulcerated, was due to intense submucosal edema. The patient had no history of taking hydroxyethylrutoside, a drug used in Europe in treating varicose veins that has been implicated in all three previously reported cases. This entity is characterized by a mixed T- and B-cell vasculitis affecting veins exclusively in the wall and mesentery of the colon and small bowel, without systemic involvement, leading to fibrointimal proliferation, thrombosis, venous occlusion, and subsequent edema and ischemic necrosis. It should be distinguished from other enterocolic phlebitides, including Behçet disease, systemic lupus erythematosus, and myointimal hyperplasia of mesenteric veins, and can be treated by local excision of the affected bowel.