Thrombophlebitis: Difference between revisions
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Revision as of 16:21, 5 February 2013
Template:Thrombophlebitis Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: White Leg; phlebitis
Overview
Thrombophlebitis is phlebitis (vein inflammation) related to a blood clot or thrombus. When it occurs repeatedly in different locations, it is known as "Thrombophlebitis migrans" or "migrating thrombophlebitis".
Causes
Thrombophlebitis is related to a blood clot (thrombus) in the vein.
Risk Factors
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).
Natural History, Complications and Prognosis
Complications
Complications are rare, but when they occur they can be serious. The most serious complication ocurs when the blood clot dislodges, travelling through the heart and occluding the dense capillary network of the lungs; this is a Pulmonary Embolism and is extremely life threatening.
Prognosis
Thrombophlebitis and other forms of phlebitis usually respond to prompt medical treatment.
Diagnosis
History and Symptoms
The following symptoms are often (but not always) associated with thrombophlebitis:
- Pain in the affected body part.
- Skin redness (not always present)
- Swelling (edema) of the extremities (ankle and foot)
Physical Examination
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.
Laboratory Findings
If the cause is not readily identifiable, tests may be performed to determine the cause, including the following:
- Blood coagulation studies
Ultrasound
Other Diagnostic Studies
- Extremity arteriography
Treatment
Medical Therapy
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 (NSAID) such as ibuprofen to reduce pain and inflammation
- Antibiotics (if infection is present)
- Support stockings and wraps to reduce discomfort
The patient 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.
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.