PHLEBOSCLEROSIS

From Big Medical Encyclopedia

PHLEBOSCLEROSIS (phlebosclerosis; Greek phleps, phlebos a vein + a sclerosis) — the consolidation of a wall of a vein connected with development in it connecting fabric.

T. comes in the outcome patol. processes, at to-rykh there is a damage and death of structural elements of a venous wall — phlebitis, thrombophlebitis, is long the existing venous stagnation (at a varicosity of the lower extremities, hron. heart failure, cirrhosis, prelum tumor of large veins, etc.), damages of walls of veins, septic processes, etc.

F. can occupy different venous pools and it is presented by three main kliniko-morfol. forms: without narrowing of a gleam of a vein, with narrowing of a gleam of a vein and a full obliteration of a gleam of a vein. The phlebosclerosis without narrowing of a gleam of a vein (varikoskleroz) develops against the background of is long the existing venous stagnation (see the Hyperemia). At the same time the vein macroscopically has an appearance of a dense rigid tube with a reinforced whitish wall and a gleam of the correct form. Degree of a sclerosis corresponds to duration and expressiveness of stagnation. Distinguish early (compensated, hypertrophic) and late (dekompensi-rovanny, atrophic) cook-koskleroza phases. The early phase is characterized by emergence on an internal cover of a vessel of blyashkovidny thickenings, in to-rykh in a significant amount glikozaminoglikana and glycoproteins are defined. Smooth muscle cells of circular and longitudinal layers are hypertrophied, rich with a glycogen, in them high activity of oxidation-reduction enzymes is noted. The inner elastic membrane is traced throughout, is thickened at the expense of a hyperplasia of elastic fibers, sometimes split. Collagenic fibers of an internal cover thin, are located rykhlo, on average and outside layers — numerous and rough. The late phase of a varikoskleroz is characterized by a diffusion thickening of an internal cover, in a cut there is coarsening of an argyrophil framework, there are coarse collagenic fibers and sites of a hyalinosis, the maintenance of glikozaminoglikan and glycoproteins decreases. The inner elastic membrane is thickened, deformed. On average a layer among growths of fibrous fabric with the phenomena of a hyalinosis atrofichny smooth muscle cells separate remained poor in a glycogen and oxidation-reduction enzymes come to light. The vasa vasorum network is reduced.

T. with narrowing of a gleam of a vein develops at phlebitis (see) with a mural thrombosis, it is characterized by disturbance of a blood-groove on a vein. Macroscopically the wall of a vein is unevenly thickened, rigid, has a whitish shade and irregular shape of a gleam on a section. Microscopically in a vascular wall it is possible to determine its border with organized blood clot by an arrangement of elastic membranes. Smooth muscle cells are replaced by fibrous fabric, collagenic fibers randomly intertwine among themselves in all layers of a wall. Sometimes the limfogistiotsitarny infiltrates which are especially often located around vasa vasorum are found.

T. with a full obliteration of a gleam of a vein (obstructive F.) develops as a result of the processes which are followed by obturatsionny thrombosis (see) its gleam, it is characterized by a total block of a blood-groove on the affected vein. Macroscopically the vein has an appearance whitish, sometimes a connective tissue plait, yellowish on a section. Microscopically in occlusive a gleam of connecting fabric most often there are no elastic fibers. Coarse collagenic fibers are located in all layers of a wall and connecting fabric, occlusive a gleam. The narrow channels and cracks covered by an endothelium, which are formed as a result of the sewerage of blood clot in hard cases have small functional value.

Wedge, a picture, the diagnosis, treatment, the forecast and prevention of the disturbances arising at a phlebosclerosis — see the Varicosity, Thrombophlebitis.

Bibliography: Zerbino D. D. and P. I Worm. Pathological anatomy of a gyusttromboflebitichesky syndrome, Arkh. patol., t. 39, No. 9, page 3, 1977; Sandpipers JI. Page and At r yu m about in L. B. About features of a phlebosclerosis at a varicosity and thrombophlebitis, in the same place, t. 32, No. 2, page 61, 1970; Robbins S. L., Angeli M. and. To and-m a r V. Basic pathology, Philadelphia,

1981. V. N. Galankin.

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