Een sprong in het diepe veneuze systeem

Based on three practical cases we show the added value of abdominal duplex investigation in the phlebology patient. We formulated four indications for abdominal duplex inves-tigation: 1. Suspicion of a phlegmasia cerulea dolens. Because the investigation can be performed immediately a treatment plan can be formulated directly. 2. Extensive varicose veins at a young age. In the case of central pathology of the deep venous system the superficial system can take the function of collateral circulation and should not be treated. 3. A venous ulcer in young patients. The treatment plan should take into account the presence or absence of pathology of the deep venous system in the abdomen. 4. A palma vein. This collateral vein between the left and right groin, that crosses the os pubis, is pathognomonic for deep venous pathology in the abdomen. The abdominal duplex investigation performed by a trained dermatologist or vascular surgeon leads to a good correla-tion between the clinical picture, the duplex investigation findings and leads to a treatment advice ‘a la carte’ for the patient.