Superficial Thrombophlebitis

Causes and Risks:
Superficial thrombophlebitis may occur after recently using a intravenous (IV) line, or after trauma to the vein. It involves an inflammatory response associated with a clot in the vein.

Risks include an increased blood clotting tendency, infection, current or recent pregnancy , varicose veins , and chemical or other irritation of the area. Prolonged sitting, standing, or immobilization increase the risk. Superficial thrombophlebitis may occasionally be associated with abdominal cancers (such as carcinoma of the pancreas ), deep vein thrombosis , thromboangiitis obliterans , and (rarely) with pulmonary embolus .

Prevention:
If an intravenous line is in use, the risk of superficial thrombophlebitis may be reduced by frequent observation of the injection site, removal if signs of inflammation develop, and routine IV site rotation.

Symptoms:
  • skin redness or inflammation along a superficial (skin) vein
  • redness of the tissue around a superficial vein
  • warmth of tissue around a superficial vein
  • tenderness or pain along a superficial vein, worse when pressure is applied over the vein
  • hardening of a superficial vein ( induration )
  • vein feeling cord-like
  • leg pain



Signs and Tests:
The health care provider makes the diagnosis of superficial thrombophlebitis primarily based on the appearance of the extremity. Frequent checks of the pulse , blood pressure , temperature, skin condition, and circulation may be required.

If the cause is not readily identifiable, tests may be performed to determine the cause, including:

Cultures of the skin or intravenous site drainage, or blood cultures , may be performed if infection is suspected.

This disease may also alter the results of the following tests:



Treatment:
The goal of treatment is reduction of inflammation.

The intravenous catheter should be removed.

Medications may include analgesics for pain, anticoagulants to prevent clot formation, thrombolytics to dissolve an existing clot, or others. Nonsteroidal antiinflammatory medication (NSAIDS) may reduce pain and inflammation. Antibiotics are prescribed if infection is present.

Support stockings and wraps may be of benefit in reducing discomfort. Elevate the extremity to reduce swelling . Keep pressure off of it to reduce pain and decrease the risk of further damage. Apply moist heat to the extremity to reduce inflammation and pain.

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

Prognosis:
Superficial thrombophlebitis is usually a benign and short term condition. Symptoms generally subside in 1 to 2 weeks, but hardness of the vein may remain for much longer.

Complications:

Note: Complications are rare.

Call Your Healthcare Provider:
Call for an appointment with your health care provider if symptoms indicate superficial thrombophlebitis may be present.

Call your health care provider if superficial thrombophlebitis has been diagnosed and symptoms do not improve with treatment or symptoms worsen, or if new symptoms occur, such as entire limb becoming pale , cold, or swollen, or if chills and fever develop.