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Phlebitis
Thrombophlebitis

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Definition

Thrombophlebitis is a condition characterized by formation of a blood clot and development of inflammation in one or more of your veins, typically in your legs. Rarely, thrombophlebitis can affect veins in your arms.

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Types

  • Superficial thrombophlebitis - involvement of a vein near the surface of the skin.
  • Deep vein thrombosis - involvement of a vein that is deep within a muscle

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Causes

  • Definitive cause is unknown.
  • Prolonged inactivity, such as sitting during a long period of travel in an airplane or automobile
  • Lengthy bed rest after a heart attack, surgery or leg fracture.
  • Paralysis of your arms or legs e.g. stroke
  • Cancer e.g. pancreatic cancer
  • Hormone replacement therapy or oral contraceptives.
  • An inherited tendency for blood clots to form.

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Symptoms

  • Warmth, tenderness and pain in the affected area
  • Redness and swelling
  • Fever
  • When a deep vein is affected, your leg may become tender, painful and swollen.
  • When a superficial vein is affected, a red, hard and tender cord may be present just under the surface of your skin
  • Have a heart pacemaker
  • Catheter in a central vein, for administering medication to treat a medical condition.
  • Increased pressure in the veins of your pelvis and legs due to pregnancy or have gone through labor (birthing process).
  • Clots in varicose veins
  • Direct injury to the vein may be due to a penetrating wound.
  • Infection in a vein, may be from other parts of the body.

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Implications

Long standing untreated thrombophlebitis of a deep vein may result in in a potentially life-threatening situation called pulmonary embolism. In this condition the clot from a deep vein gets dislodged and travels to your lung where it can block an artery and can be fatal. A deep vein thrombosis may also damage valves in the veins in your legs pumping the blood back from your legs to your heart. The pooling of blood can lead to ballooning of the veins, resulting in varicose veins. In some cases, the pooling may worsen and cause swelling of your legs. With chronic swelling and increased pressure, skin discoloration called stasis pigmentation may occur. Skin ulcers may also develop. Recurrent episodes of deep vein thrombosis could obstruct the vein permanently. If there is a congenital heart defect such as an atrial or ventricular septal defect, a clot can enter your arterial circulation and cause a heart attack or stroke.

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What You Can Do

  • Medications
    • Injection of a blood-thinning medication, such as heparin, will prevent clots from growing. After the initial heparin treatment, treatment is continued with oral anticoagulant warfarin (Coumadin) to prevent the clots from forming.

  • Wear you support stockings daily to prevent recurrent swelling and reduce the of complications of deep vein thrombosis.

  • Elevate your leg if it is swollen

  • Apply heat to the involved area, using a warm washcloth for 15 to 30 minutes, two or three times daily.

  • Insertion of a filter into the abdominal aorta is needed to prevent clots that might break loose in leg veins, from lodging in your lungs.

  • Varicose vein stripping
    • This procedure involves removing a long vein through small incisions

  • Surgery.
    • This procedure is performed to treat chronic blocking of a vein. The surgeon bypasses the blocked vein, or opens up the vein (angioplasty). Once the vein has been opened up, a stent which is a very tiny, lattice-work coil is inserted to keep the vein open.

  • Prevention
    • If you are in an airplane, walk around the airplane cabin once an hour or so. If you are driving, stop every hour, stretch your legs and walk around for a few minutes before continuing your journey.
    • If your work requires you to be sedentary, move your legs frequently, flex your ankles, or press your feet against the seat in front of you.
    • Take an aspirin just before a long trip. Aspirin interferes with your blood's clotting action.

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Thrombophlebitis