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13286 Surgery

A 59-year-old woman, had a left femoral venous thrombosis during a pregnancy 30 year ago. Her left greater saphenous vein had been stripped at age 21. She now presents with a large non healing ulceration over the medial left calf, which has continuously progressed despite bed rest, elevation, and use of a suppo stocking. Descending phlebography of the left leg demonstrates a patent deep venous system, with free flow of dye from the groin to foot. The first profunda femoris valve is competent. Appropriate management might include which of the following:

ADivision of the superficial femoral vein in the groin and transposition of its distal end onto the profunda femoris vein below the level of the competent profunda valve
BSaphenous venous crossover graft with asastomosis of the end of the right saphenous vein onto the side of competent femoral vein
CLigated iliofemoral venous thrombectomy with creation of the temporary aeriovenous fistula
DSubfascial ligation of perforating veins in the left calf
Surgery
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13291 Surgery

The fold of Treves is

AThe fold of mucous membrane projecting into the lumen of the rectum
BThe ilio-appendicular fold of peritoneum
CThe fold of mucous membrane around the papilla of Vater
DThe fold of peritoneum over the inferior mesenteric vein
Surgery
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