TY - JOUR T1 - Bleeding from varicose veins: advice in primary care and referral JF - British Journal of General Practice JO - Br J Gen Pract SP - 448 LP - 449 DO - 10.3399/bjgp22X720677 VL - 72 IS - 722 AU - Bruce Campbell AU - Chris Dilley AU - Manj Gohel Y1 - 2022/09/01 UR - http://bjgp.org/content/72/722/448.abstract N2 - Fear of bleeding from varicose veins is common and bothers many patients, as varicose veins are so prevalent.1 When bleeding has occurred, then the risk of further bleeds is high and urgent treatment is indicated for the underlying varicose veins. Despite the potential seriousness of this complication, and clear National Institute for Health and Care Excellence (NICE) guidance on varicose veins, there seems to be quite widespread uncertainty about who is at risk, and precisely what to do when and after bleeding has occurred.2,3 There is surprisingly little in the literature about this condition.3,4Bleeding from varicose veins can be fatal, because of frailty and incapacity, ignorance about what to do when it happens, or both.3,5 It is unclear how many people die as a result of bleeding from their varicose veins, but a report from Australia found that it accounted for 1/1000 autopsies.6 The limited number of case reports and published case series are dominated by deaths of people who are living alone, who are vulnerable with physical or mental disability, and with contributing factors such as anticoagulant medication or alcohol consumption.3–5The risk of bleeding from varicose veins that are covered by … ER -