title: Abdominal hypertension and venous insufficiency of lower limbs: is there a relationship?
abstract: OBJECTIVE
  The purpose of our study is to understand the compression, by subcutaneous fat in obese patients, who present a chronic increase in abdominal pressure, and on the sapheno-femoral cross. Such increase would result in a chronic venous insufficiency (CVI) of lower limbs and, if possible, it will be quantified also according to the posture.
  
  
  METHODS
  We studied two different groups of patients with CVI: obese and non-obese. The severity of CVI was classified with the CEAP classification or by the standards of recent classifications. Abdominal pressure, by means of Kron's method, and anterior-sagittal diameter were measured in some of the non-obese patients (4 males and 4 females) and in all the obese patients. The diameter of the femoral vein of both groups of patients in supine, sitting and standing positions was also measured.
  
  
  RESULTS
  We found a higher incidence of CEAP 5-6 classes in the obese group than in the non-obese one; we also saw a higher incidence of classes 1-2 in the non-obese group than in the obese one. Moreover, Kron's method showed a significant difference in abdominal pressure in relation to the BMI and the increase in the femoral vein diameter appears to be related to the weight and to the position.
  
  
  CONCLUSIONS
  It was clear that the clinical manifestations of CVI are more severe in obese than in non-obese patients. Obesity in our study clearly acts with a continuous compressive action on the veins of the abdomen and thereby on the femoral vein, further contributing to a retrograde flow. So we tried to quantify an entity that until now could only be assumed.
authors.forename: Domenico
authors.initials: D
authors.lastname: Parmeggiani
authors.forename: Marco
authors.initials: M
authors.lastname: Apperti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Pascale
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ambrosino
authors.forename: Imma
authors.initials: I
authors.lastname: Madonna
authors.forename: Roberto
authors.initials: R
authors.lastname: Peltrini
authors.forename: Sarah
authors.initials: S
authors.lastname: Apperti
authors.forename: Adelmo
authors.initials: A
authors.lastname: Gubitosi
authors.forename: Umberto
authors.initials: U
authors.lastname: Parmeggiani
mesh_terms: D005260:Female; D005268:Femoral Vein; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000150:complications*; D008297:Male; D009765:Obesity / Q000150:complications*; D012501:Saphenous Vein; D014689:Venous Insufficiency / Q000209:etiology*