Thrombophlebitis

Definition

Phlebitis is an inflammation of a vein; thrombophlebitis is vein inflammation related to a blood clot.

Causes, incidence, and risk factors

Thrombophlebitis is related to a blood clot (thrombus) in the vein. Risk factors include prolonged sitting and disorders related to blood clotting.

Specific disorders associated with thrombophlebitis include superficial thrombophlebitis (affects veins near the skin surface) and deep venous thrombosis (affects deeper, larger veins).

Symptoms

The following symptoms are often associated with thrombophlebitis:

• tenderness over the vein
• pain in the part of the body affected
• skin redness or inflammation (not always present)

Signs and tests

The health care provider makes the diagnosis primarily based on the appearance of the affected area. Frequent checks of the pulse, blood pressure, temperature, skin condition, and circulation may be required.

If the cause is not readily identifiable, tests may be performed to determine the cause, including the following:

• Doppler ultrasound
• Extremity arteriography
• Blood coagulation studies

Treatment

For more specific recommendations, see the particular condition. In general, treatment may include the following:

• Medications
  • analgesics (pain medications)
  • anticoagulants or blood thinners to prevent new clot formation
  • thrombolytics to dissolve an existing clot
  • nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen to reduce pain and inflammation
  • antibiotics (if infection is present)
• Support stockings and wraps to reduce discomfort

You may be advised to do the following:

• Elevate the affected area to reduce swelling.
• Keep pressure off of the area to reduce pain and decrease the risk of further damage.
• Apply moist heat to reduce inflammation and pain.

Surgical removal, stripping, or bypass of the vein is rarely needed but may be recommended in some situations.

Expectations (prognosis)

Thrombophlebitis and other forms of phlebitis usually respond to prompt medical treatment.

Complications

Complications are rare, but when they occur they can be serious.

Calling your health care provider

Call your health care provider if symptoms indicate thrombophlebitis may be present.

Call your health care provider promptly if you have or suspect you have thrombophlebitis and symptoms do not improve with treatment. Also call promptly if symptoms worsen or if new symptoms occur, such as an entire limb becoming pale, cold, or swollen or if chills and fever develop.

Prevention

Routine changing of intravenous (IV) lines helps to prevent phlebitis related to IV lines. See the specific disorders associated with thrombophlebitis for other preventive measures.

Illustrations

Deep venous thrombosis, ileofemoral

Venous blood clot

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