الفهرس 
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Abstract
The study was conducted in vascular and Endovascular surgery department in Tanta university hospital. The study was conducted on 50 pediatric patients (24 male and 26 female) who presented by primary varicose veins and study was on management of varicose veins in this pediatrics patients. Each patient was assessed through: full history taken, complete general and local examination, classification of patient clinical picture according to CEAP classification and patient symptoms according to venous disability score, laboratory investigation, and venous duplex. The age of study group ranged from 10 to 18 years old with mean age 15.48 ± 2.03 years and there were 24 male (48%) and 26 female (52%). Twenty patients (40%) were working and 30 patients (60%) not working, 37 patients (74%) with positive family history and 13 patients (26%) were negative family history, 18 patients (36%) were playing sport (including 10 male patients (56%) going to gym for body building as preparation for application to military academy) and 32 patients (64%) not and 15 patients (30%) were overweight and 5 patients (10%) were obese. Clinical presentation 31 patients (62%) were C1 according to CEAP classification, 6 patients (12%) were C2, 11 patients (22%) were C3 and 2 patients (4%) were C4. Twenty patients (40%) were complaining from pain, 10 patients (20%) complaining as requirement of application to military acamdy , 5 patients (10%) complaining from cosmetic disappointed, 2 patients (4%) came with thrombosis (STP of GSV), 11 patients (22%) presented with pain and lower limb edema and 2 patients presented with bleeding varicosities. Fifteen patients (30%) asymptomatic score (0), 20 patients (40%) symptomatic but able to carry out usual activates without compressive therapy score (1) and 15 patients (30%) can carry usual activity with compression or leg elevation score (2). Injection sclerotherapy done in 26 patients (52%), stab avulsion and perforators ligation done in 13 patient (26%) mixed in two cases with sclerotherapy in cases with bleeding VV, classical stripping done in 5 patients (10%), stocking and conservative management in 5 patients (10%) and one patient operated with endovenous laser ablation. VCSS score pre intervention and management of all cases the mean vcss score was 5.70 ± 2.53 improved to 1.84 ± 0.79 at one week post and then improved to 0.92 ± 0.57 after one month, also improved to 0.32 ± 0.55 after three months from intervention.
To conclude: • Varicose veins in pediatrics are rare. • Pediatrics patients may be presented by dilated GSV as adult patients however ostial reflux is less common than adult patients. • Injection sclerotherapy is safe in pediatrics and it is the most used intervention in the study. • Foam sclerotherapy during surgery as a treatment of acute bleeding reticular varicose veins. • Stab avulsion and perforators ligation is safe and effective in pediatrics patients with varicose veins with perforator reflux which is common in pediatrics patients. • No cases of chronic venous ulcer in pediatric age group were found in this study.