Nadeem Alam Zubairi, Bari A U, Tariq Mahmood.
Klippel Trenaunay Syndrome.
J Coll Physicians Surg Pak Jan ;14(7):423-4.

An eight years old girl child presented with abnormal gait and recurrent painful swellings over both legs. She started having these symptoms since second year of age increasing for the last two years. There was history of mild to moderate degree of fever accompanied with painful swellings. She was not mentally retarded and never had any seizure or persisting headache. On physical examination, she was having asymmetry in size of the upper as well as lower limbs. Right leg was grossly larger in diameter and length as compared to left leg. Right upper limb was also appreciably larger and bulkier. Three toes, (two of the left and one of the right foot) were grossly hypertrophied. Right lower limb was more oedematous. Prominent varicosities and cellulitic lesions were also seen on that side. Port wine stain was clearly demarcated on left leg. X-Ray of the limbs confirmed disparity in length of the limbs on both sides and increased soft tissue shadow of right limbs. She did not have any port wine stain or venous malformation elsewhere over the body. She was initially managed conservatively. Cellulitis settled with oral antibiotics and pain was relieved with analgesics. Her parents were not willing for corrective surgery of the right lower limb (epiphysiodesis), therefore she was advised elastic garments by the orthopedic surgeon and to report back in case of any complications (bleeding, cellulitis or appearance of enlarged varicosities). It has been for the last eight months (after initial presentation) that she is doing well with elastic garments and has not developed any complication.

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