Complaints of swelling bu...

A 54 years male patient got admitted to the hospital with complaints of swelling bulging of veins in the lower limbs. He had noticed lower extremity swelling about five years ago and then, for one year, has been plagued with progressive leg pain. 

The patient has undergone surgery for humorous fracture six months back. He has an unremarkable family history. Personal history remarks that he is a smoker and an infrequent alcoholic with normal sleep and appetite. On further inquiry, he also represents restlessness, occasional cramping bilaterally, feeling tired and heavy at the end of the day. 

On physical assessment, his lower extremity symptoms possess a bulging viscosity on his left and right lower legs associated with achiness, as shown in the figure. On investigation, haemoglobin on the more downside (8.6 gm/dl) for which the patient underwent transfusions and haemoglobin improved over ten days (12.5 gm/dl). He was diagnosed with irregular blood flow in lower limbs on the Doppler test. The patient was diagnosed with varicose veins.