Superficial thrombophlebitis - Hypertension and vascular diseases

Superficial thrombophlebitis

Definition

Inflammation of veins combined with clot formation.

Aetiology/pathophysiology

Thrombophlebitis arising in a previously normal vein may result from trauma, irritation from intravenous infusion or the injection of a noxious agent.

Spontaneous thrombophlebitis almost invariably arises in a varicose vein due to stasis, with thrombus formation and inflammation.

Clinical features

The pain may be dull or burning, usually superficial and on examination there may be one or more visible cord-like swellings, which are firm and tender with associated erythema.

Complications

If there is a portal of entry, e.g. previous site of cannula, it may become infected, causing a cellulitis. Thrombosis in a superficial vein does not cause pulmonary embolism.

Investigations

No investigations are necessary, except to diagnose underlying deep venous insufficiency.

Management

The condition usually responds to symptomatic treatment with rest, elevation of the limb and non-steroidal antiinflammatory drugs. Anti-coagulants are not necessary. After the acute attack, treatment of underlying chronic venous insufficiency may be necessary, sclerotherapy or laser therapy may be used as treatment for varicose veins.

Prognosis

Recurrence is common.