THROMBOPHLEBITIS, SUPERFICIAL

General Information

DEFINITION--Inflammation and small blood clots in a superficial vein, usually in the legs, primarily caused by infection or injury. This type of inflammation seldom causes clots to break loose and flow in the bloodstream, as does deep-vein thrombosis.

BODY PARTS INVOLVED--Superficial veins, usually in the legs.

SEX OR AGE MOST AFFECTED

• Both sexes, but more common in females.
• All ages, but most common in adults.

SIGNS & SYMPTOMS

• Hardness of superficial vein (cord-like).
• Redness, tenderness and pain in the affected area.
• Fever (sometimes).

CAUSES--

Increased fibrin and clotting of red blood cells in a vein due to impaired blood flow. This prevents blood from returning to the heart. The blood below the clot stays there forcing fluid into the tissues, causing swelling (edema). The veins and surrounding area may become inflamed and tender.

• Illness or surgery with long bed confinement.
• Injury or infection that damages a vein.
• Congestive heart failure.

RISK INCREASES WITH

• Smoking; obesity.
• Use of birth-control pills. Combining birth-control pills and smoking greatly increases risk.
• Occupations requiring long periods of standing or sitting.
• Varicose veins; surgery, trauma, burns, infections; pregnancy; intravenous drug abuse; blood vessel disorders.

HOW TO PREVENT

• Don't smoke if you take birth-control pills.
• If confined to bed for any reason, move the legs as much as possible to prevent pooling of blood in the veins.
• Avoid using any drug intravenously.
• Hospitalized patients should take preventive measures including medications, special stockings or compression boots.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Laboratory blood studies, if the cause is not immediately apparent.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Treatment usually involves rest and elevation of the extremity, sometimes medications depending on the cause.

POSSIBLE COMPLICATIONS

• May lead to deep vein thrombosis (clots within the deep veins).
• If there is an infection and it remains untreated, it could lead to blood poisoning.

PROBABLE OUTCOME--Usually curable in 2 weeks.

How To Treat

GENERAL MEASURES--

• Wearing elastic stockings or using a wrapped elastic bandage may hasten the blood flow through the veins, relieving discomfort and helping prevent further clot formation. Don't wear garters or knee-high hosiery.
• To relieve pain, use wrapped soaks (see Soaks in Appendix).
• Stop smoking and stop taking birth-control pills. If you continue both, the next episode of vein clots may be a dangerous, deep-vein clot.

MEDICATION--Your doctor may prescribe:

• Nonsteroidal anti-inflammatory drugs, including aspirin, to decrease inflammation and pain.
• Antibiotics, if bacterial infection is suspected (rare).
• Topical ointments to relieve any itching.

ACTIVITY--Bed rest with the affected limb elevated may be helpful for 1 or 2 days. Move the feet, ankles and legs often. When the inflammation begins to subside, resume normal activity slowly. Rest often. Don't sit or stand for prolonged periods, and don't cross legs.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of superficial thrombophlebitis.
• The following occur during treatment: Fever of 102F (38.9C) or higher. Intolerable pain. Coughing blood. Shortness of breath. Chest pain. Swelling of leg or foot.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.