Thrombophlebitis: Difference between revisions
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==Risk Factors== | ==Risk Factors== | ||
The following are associated with an increased risk of thrombophlebitis:<ref name="pmid26099257">{{cite journal |vauthors=Nasr H, Scriven JM |title=Superficial thrombophlebitis (superficial venous thrombosis) |journal=BMJ |volume=350 |issue= |pages=h2039 |year=2015 |pmid=26099257 |doi= |url=}}</ref><ref name="pmid8624665">{{cite journal |vauthors=Guex JJ |title=Thrombotic complications of varicose veins. A literature review of the role of superficial venous thrombosis |journal=Dermatol Surg |volume=22 |issue=4 |pages=378–82 |year=1996 |pmid=8624665 |doi= |url=}}</ref><ref name="pmid2195069">{{cite journal |vauthors=Samlaska CP, James WD |title=Superficial thrombophlebitis. II. Secondary hypercoagulable states |journal=J. Am. Acad. Dermatol. |volume=23 |issue=1 |pages=1–18 |year=1990 |pmid=2195069 |doi= |url=}}</ref><ref name="pmid25521017">{{cite journal |vauthors=Scott G, Mahdi AJ, Alikhan R |title=Superficial vein thrombosis: a current approach to management |journal=Br. J. Haematol. |volume=168 |issue=5 |pages=639–45 |year=2015 |pmid=25521017 |doi=10.1111/bjh.13255 |url=}}</ref> | |||
*[[Chronic venous disease]], such as [[varicose veins]] (most common risk factor)<ref name="pmid15738838">{{cite journal |vauthors=Gillet JL, Allaert FA, Perrin M |title=[Superficial thrombophlebitis in non varicose veins of the lower limbs. A prospective analysis in 42 patients] |language=French |journal=J Mal Vasc |volume=29 |issue=5 |pages=263–72 |year=2004 |pmid=15738838 |doi= |url=}}</ref><ref name="pmid15906904">{{cite journal |vauthors=De Maeseneer MG |title=Superficial thrombophlebitis of the lower limb: practical recommendations for diagnosis and treatment |journal=Acta Chir. Belg. |volume=105 |issue=2 |pages=145–7 |year=2005 |pmid=15906904 |doi= |url=}}</ref> and [[chronic venous insufficiency]] | |||
*[[Venous]] [[thrombosis]], whether a prior history or current [[DVT]]<ref name="pmid8624665">{{cite journal |vauthors=Guex JJ |title=Thrombotic complications of varicose veins. A literature review of the role of superficial venous thrombosis |journal=Dermatol Surg |volume=22 |issue=4 |pages=378–82 |year=1996 |pmid=8624665 |doi= |url=}}</ref> | |||
*[[Venous stasis]], associated with prolonged [[immobility]] and prolonged [[surgery]] | |||
*[[Hypercoagulable states]], such as [[malignancy]]<ref name="pmid15738838">{{cite journal |vauthors=Gillet JL, Allaert FA, Perrin M |title=[Superficial thrombophlebitis in non varicose veins of the lower limbs. A prospective analysis in 42 patients] |language=French |journal=J Mal Vasc |volume=29 |issue=5 |pages=263–72 |year=2004 |pmid=15738838 |doi= |url=}}</ref>, [[pregnancy]] and the use of [[estrogen]]-based [[hormone therapy]]<ref name="pmid9364982">{{cite journal |vauthors=McColl MD, Ramsay JE, Tait RC, Walker ID, McCall F, Conkie JA, Carty MJ, Greer IA |title=Risk factors for pregnancy associated venous thromboembolism |journal=Thromb. Haemost. |volume=78 |issue=4 |pages=1183–8 |year=1997 |pmid=9364982 |doi= |url=}}</ref> | |||
*[[Trauma]] to the [[Blood vessel|vessel]], such as [[IV]] [[cannulation]], [[sclerotherapy]] and surgical [[ablation]] | |||
*[[Obesity]] | |||
==[[Thrombophlebitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== | ==[[Thrombophlebitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
Revision as of 21:30, 16 February 2017
Template:Thrombophlebitis For patient information, click here
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: White Leg; phlebitis
Overview
Historical Perspective
- In 1913, Burnham AC discussed thrombophlebitis in postoperative patients.[1]
- Historically, the treatment of thrombophlebitis was purely surgical and consisted of removal of the thrombosed vein.[2]
Classification
Thrombophlebitis can be classified according to the cause into:[3]
Type of Thrombophlebitis | Description |
---|---|
Sterile | Most common type of thrombophlebitis |
Traumatic | Associated with the following conditions:
|
Infective | Mostly due to prolonged IV cannulation |
Migratory | Recurrent thrombophlebitis at various sites. Associated with an underlying malignancy, most commonly adenocarcinoma of the pancreas |
Thrombophlebitis may also be classified according to the site into:[4]
- Superficial thrombophlebitis of the lower limb: most common location and it involves the great and short saphenous veins
- Superficial thrombophlebitis of the arms
- Superficial thrombophlebitis of the breast: also known as Mondor's disease
- Superficial thrombophlebitis of the abdominal wall
Pathophysiology
Pathogenesis
Microscopic Pathology
Genetics
Associated Conditions
Thrombophlebitis may be associated with the following conditions:
- Coagulation abnormalities:[3][5]
- Thromboangiitis obliterans (Buerger's Disease)[6]
- Underlying malignancy, especially adenocarcinoma of the pancreas in the case of migratory thrombophlebitis[7][8]
Causes
Common Causes
- Deep vein thrombosis
- Drug side effects
- Intravenous infusion
- IV catheter infection
- Levamisole-induced vasculopathy
- Penicillin G potassium infusion
- Thromboangiitis obliterans
- Thrombophlebitis migrans
- Varicose veins
- Vein injury
Causes by Organ System
Causes in Alphabetical Order
The unnamed parameter 2= is no longer supported. Please see the documentation for {{columns-list}}.
3Differentiating Thrombophlebitis from other Diseases
Epidemiology and Demographics
Epidemiology
Incidence
- The incidence of thrombophlebitis is estimated at 100 per 100,000 cases.[4][9]
- Thrombophlebitis is 6 times more common than DVT.[4]
Demographics
Age
- The incidence of thrombophlebitis is more common with increasing age.[4]
Risk Factors
The following are associated with an increased risk of thrombophlebitis:[3][10][11][4]
- Chronic venous disease, such as varicose veins (most common risk factor)[12][13] and chronic venous insufficiency
- Venous thrombosis, whether a prior history or current DVT[10]
- Venous stasis, associated with prolonged immobility and prolonged surgery
- Hypercoagulable states, such as malignancy[12], pregnancy and the use of estrogen-based hormone therapy[14]
- Trauma to the vessel, such as IV cannulation, sclerotherapy and surgical ablation
- Obesity
Natural History, Complications and Prognosis
Screening
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Ultrasound | Other Imaging Findings | Other Diagnostic Studies
Treatment
Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
Case Studies
- ↑ Burnham AC (1913). "II. Postoperative Thrombophlebitis". Ann. Surg. 57 (2): 151–62. PMC 1407408. PMID 17862964.
- ↑ Homans J (1928). "THROMBOPHLEBITIS OF THE LOWER EXTREMITIES". Ann. Surg. 87 (5): 641–51. PMC 1398549. PMID 17865873.
- ↑ 3.0 3.1 3.2 Nasr H, Scriven JM (2015). "Superficial thrombophlebitis (superficial venous thrombosis)". BMJ. 350: h2039. PMID 26099257.
- ↑ 4.0 4.1 4.2 4.3 4.4 Scott G, Mahdi AJ, Alikhan R (2015). "Superficial vein thrombosis: a current approach to management". Br. J. Haematol. 168 (5): 639–45. doi:10.1111/bjh.13255. PMID 25521017.
- ↑ Martinelli I, Cattaneo M, Taioli E, De Stefano V, Chiusolo P, Mannucci PM (1999). "Genetic risk factors for superficial vein thrombosis". Thromb. Haemost. 82 (4): 1215–7. PMID 10544900.
- ↑ Olin JW (2000). "Thromboangiitis obliterans (Buerger's disease)". N. Engl. J. Med. 343 (12): 864–9. doi:10.1056/NEJM200009213431207. PMID 10995867.
- ↑ Diaconu C, Mateescu D, Bălăceanu A, Marcu M, Jianu V, Stănică A (2010). "Pancreatic cancer presenting with paraneoplastic thrombophlebitis--case report". J Med Life. 3 (1): 96–9. PMC 3019029. PMID 20302205.
- ↑ Varki A (2007). "Trousseau's syndrome: multiple definitions and multiple mechanisms". Blood. 110 (6): 1723–9. doi:10.1182/blood-2006-10-053736. PMC 1976377. PMID 17496204.
- ↑ Di Nisio M, Wichers IM, Middeldorp S (2013). "Treatment for superficial thrombophlebitis of the leg". Cochrane Database Syst Rev (4): CD004982. doi:10.1002/14651858.CD004982.pub5. PMID 23633322.
- ↑ 10.0 10.1 Guex JJ (1996). "Thrombotic complications of varicose veins. A literature review of the role of superficial venous thrombosis". Dermatol Surg. 22 (4): 378–82. PMID 8624665.
- ↑ Samlaska CP, James WD (1990). "Superficial thrombophlebitis. II. Secondary hypercoagulable states". J. Am. Acad. Dermatol. 23 (1): 1–18. PMID 2195069.
- ↑ 12.0 12.1 Gillet JL, Allaert FA, Perrin M (2004). "[Superficial thrombophlebitis in non varicose veins of the lower limbs. A prospective analysis in 42 patients]". J Mal Vasc (in French). 29 (5): 263–72. PMID 15738838.
- ↑ De Maeseneer MG (2005). "Superficial thrombophlebitis of the lower limb: practical recommendations for diagnosis and treatment". Acta Chir. Belg. 105 (2): 145–7. PMID 15906904.
- ↑ McColl MD, Ramsay JE, Tait RC, Walker ID, McCall F, Conkie JA, Carty MJ, Greer IA (1997). "Risk factors for pregnancy associated venous thromboembolism". Thromb. Haemost. 78 (4): 1183–8. PMID 9364982.