Lower limb varicose veins are a common complication of bipedal human movement and deep-vein thrombosis. However, they may have
unusual causes, e.g. forming as collaterals around an obstruction or resulting from vascular malformations. Surgery in these cases can be
inappropriate or harmful. Five cases of lower limb varicose veins in which there was underlying pathology highlight the fact that cursory
examination of patients with varicose veins and inappropriate special investigations can miss rare but significant underlying pathology.
Patients should be examined systematically, and varicose veins in unusual situations should alert the clinician. Inappropriate surgery can