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Thrombophlebitis

Definition

Thrombophlebitis is swelling (inflammation) of a vein caused by a blood clot.

Alternative Names

Phlebitis

Causes, incidence, and risk factors

The following increase your chances for thrombophlebitis:

• Being hospitalized for a major surgery or with a major illness
• Disorders that make you more likely to develop blood clots
• Sitting for a long period of time (such as on a long airplane trip)

There are two main types of thrombophlebitis:

• Deep venous thrombosis (affects deeper, larger veins)
• Superficial thrombophlebitis (affects veins near the skin surface)

Symptoms

The following symptoms are often associated with thrombophlebitis:

• Inflammation (swelling) in the part of the body affected
• Pain in the part of the body affected
• Skin redness (not always present)
• Warmth and tenderness over the vein

Signs and tests

The health care provider can usually diagnose the condition based on how the affected area looks. You may need to have your pulse, blood pressure, temperature, skin condition, and circulation frequently checked to make sure you don't have complications.

If the cause cannot be easily identified, one or more of the following tests may be done:

• Blood coagulation studies
• Doppler ultrasound
• Venography

Treatment

In general, treatment may include support stockings and wraps to reduce discomfort as well as medications such as:

• Analgesics (pain killers)
• Antibiotics (if infection is present)
• Anticoagulants (blood thinners) to prevent new clots from forming
• Nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen to reduce pain and inflammation
• Thrombolytics to dissolve an existing clot

You may be told to do the following:

• Keep pressure off of the area to reduce pain and decrease the risk of further damage
• Raise the affected area to reduce swelling

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

For more specific recommendations, see the particular condition (superficial thrombophlebitis or deep venous thrombosis).

Support Groups

Expectations (prognosis)

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

Complications

Superficial thrombophlebitis rarely causes complications.

Complications of deep vein thrombosis include blood clots in the lungs (pulmonary embolism) or chronic pain and swelling in the leg.

Calling your health care provider

Call your health care provider if you have symptoms of thrombophlebitis.

Call your health care provider promptly if thrombophlebitis symptoms do not improve with treatment, if symptoms get worse, or if new symptoms occur (such as an entire limb becoming pale, cold, or swollen).

Prevention

Routine changing of intravenous (IV) lines helps to prevent thrombophlebitis related to IVs.

If you are taking a long car or plane trip, walk or stretch your legs once in a while and drink plenty of liquids. Wearing support hose may help.

If you are hospitalized, your doctor may prescribe medicine to prevent deep venous thrombosis.

References

Lim W, Crowther MA, Ginsberg JS. Venous thromboembolism. In: Hoffman R, Benz EJ, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 135.

DeLoughery TG. Venous Thrombotic Emergencies. Emergency Medicine Clinics of North America. August 2009;27(3).