Venous insufficiency, obesity associated I83.-

Venous insufficiency in obese patients, caused by increased intra-abdominal pressure and the correlating iliofemoral venous pressure.

A correlation between an increased BMI and the sagittal abdominal diameter, the iliofemoral venous pressure and the bladder pressure has been proven and well documented. Thus, an increased BMI is accompanied by a reduced flow rate in the femoral vein. The consequences are the cutaneous changes of chronic venous insufficiency such as stasis dermatitis, dermatoliposclerosis, hyperpigmentation and ulcer formation.

Weight-optimizing measures; sufficient compression therapy with low elastic materials; symptomatic ulcer therapy. According to the obesity guideline, an obesity surgery with a BMI>50kg/sqm without contraindication is considered as primary indication.

The ulcerations that occur in connection with obesity have some special features. They are atypically located on the dorsal or ventrolateral lower leg. Apparently, banal traumas are the cause of ulcer formation.

1. Doerler M et al (2013) Venous leg ulcer caused by obesity associated dependency syndrome case report and discussion of the pathogenesis and treatment. Phlebology 42: 205-208
2. Scholl L et al (2017) Ulcer in obesity-associated chronic venous insufficiency. Dermatologist 68: 560-565