Thrombophlebitis: Difference between revisions
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== Definition == | == Definition == | ||
Thrombophlebitis is a circulatory condition that occurs when a [[Blood Physiology|blood]] clot, which developed due to a venous inflammation, inhibits the blood flow. <ref name=":1">Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg (Cochrane Review). Cochrane Database Syst Rev 2018;(2):CD004982.</ref> Most commonly, thrombophlebitis affects the superficial veins of the extremities (arms and legs). Related conditions that may be used as a synonym are phlebitis, phlebothrombosis, and venous thrombosis. <ref name=":2">Thrombophlebitis. Farlex Partner Medical Dictionary, 2012. Available from: https://medical-dictionary.thefreedictionary.com/thrombophlebitis (last accessed: 26.09.2020).</ref> The word is compounded of the term "thrombus", which describes a blood clot that was formed inside a blood vessel, and "phlebitis", which is the medical term for the inflammation of a vein. | Thrombophlebitis is a circulatory condition that occurs when a [[Blood Physiology|blood]] clot, which developed due to a venous inflammation, inhibits the blood flow. <ref name=":1">Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg (Cochrane Review). Cochrane Database Syst Rev 2018;(2):CD004982.</ref> Most commonly, thrombophlebitis affects the superficial veins of the extremities (arms and legs). Related conditions that may be used as a synonym are phlebitis, phlebothrombosis, and venous thrombosis. <ref name=":2">Thrombophlebitis. Farlex Partner Medical Dictionary, 2012. Available from: https://medical-dictionary.thefreedictionary.com/thrombophlebitis (last accessed: 26.09.2020).</ref> The word is compounded of the term "thrombus", which describes a blood clot that was formed inside a blood vessel, and "phlebitis", which is the medical term for the inflammation of a vein. | ||
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===Types=== | ===Types=== | ||
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The cause of thrombophlebitis in the upper extremity is most commonly the insertion of venous catheters into peripheral veins. <ref name=":3" /> This complication is believed to originate from inflammation processes caused by the trauma of the insertion, the possible invasion of bacteria in the area of the catheter, and the effect of the inserted chemicals. <ref name=":3" /> | The cause of thrombophlebitis in the upper extremity is most commonly the insertion of venous catheters into peripheral veins. <ref name=":3" /> This complication is believed to originate from inflammation processes caused by the trauma of the insertion, the possible invasion of bacteria in the area of the catheter, and the effect of the inserted chemicals. <ref name=":3" /> | ||
=== | ===Pathogenesis=== | ||
The pathway of the disease can be split into two stages: | The pathway of the disease can be split into two stages: | ||
# Inflammation process in the vessel. | # Inflammation process in the vessel. | ||
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==Complications== | ==Complications== | ||
Although thrombophlebitis has been considered a fairly benign disease, some research indicates that there is a correlation of higher prevalence of deep vein thrombosis (phlebothrombosis) in patients with superficial thrombophlebitis. <ref name=":1" /> | Although thrombophlebitis has been considered a fairly benign disease, some research indicates that there is a correlation of a higher prevalence of deep vein thrombosis (phlebothrombosis) in patients with superficial thrombophlebitis. <ref name=":1" /> | ||
== Prevention == | == Prevention == | ||
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== Treatment == | == Treatment == | ||
Treatment may depend on location, extent, symptoms, and underlying medical condition, but in general, it can be treated with: | Treatment may depend on location, extent, symptoms, and underlying medical condition, but in general, it can be treated with: | ||
*warm compresses | * warm compresses | ||
*elevation of the limb | * elevation of the limb | ||
*encouraging circulation (walking around) | * encouraging circulation (walking around) | ||
*external compression with fitted stockings | * external compression with fitted stockings | ||
*anti-inflammatory medication  | * anti-inflammatory medication  | ||
Recovery can take from a few weeks to a couple of months. <ref name=":6">Vorvick L, Thrombophlebitis. Medline, 5 oct 2010.</ref><br> | |||
Recovery can take from a few weeks to a couple of months. <ref name=" | |||
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== Physical Therapy Treatment == | == Physical Therapy Treatment == | ||
---to be edited--- | |||
== References == | == References == | ||
Revision as of 19:18, 26 September 2020
Original Editor - Dieter Schuddinck
Top Contributors - Special:Anna Fuhrmann/Thrombophlebitis
Definition[edit | edit source]
Thrombophlebitis is a circulatory condition that occurs when a blood clot, which developed due to a venous inflammation, inhibits the blood flow. [1] Most commonly, thrombophlebitis affects the superficial veins of the extremities (arms and legs). Related conditions that may be used as a synonym are phlebitis, phlebothrombosis, and venous thrombosis. [2] The word is compounded of the term "thrombus", which describes a blood clot that was formed inside a blood vessel, and "phlebitis", which is the medical term for the inflammation of a vein.
Types[edit | edit source]
Multiple types of thrombophlebitis are known, sorted by highest to lowest prevalence below.
- Superficial thrombophlebitis: occurs in the veins located under the skin
- Thrombophlebitis migrans: multiple inflammation nidi in different areas[2]
A deep vein thrombosis, which mostly occurs without any inflammation process, will usually be referred to as a phlebothrombosis. [4]
Causes[edit | edit source]
The causes of superficial thrombophlebitis are different for the lower and upper extremities. For the lower extremity, the causes are often a combination of a suboptimal condition of the veins and disease predispositions, as well as the exposure to risk factors, all of which include: [3]
- varicous veines
- immobilisation (also pre- and post-surgery)
- trauma or surgical interventions (especially including interventions which include the removal of lymph nodes)
- pregnancy, and maternal and birth-related conditions
- cancerous malformations
- obesity
- history of thrombosis
- autoimmune diseases
- use of hormonal therapies (e.g. the contraceptive pill or hormonal replacement therapy)
- smoking (also as a higher associated risk factor to arteriosclerosis)
The cause of thrombophlebitis in the upper extremity is most commonly the insertion of venous catheters into peripheral veins. [3] This complication is believed to originate from inflammation processes caused by the trauma of the insertion, the possible invasion of bacteria in the area of the catheter, and the effect of the inserted chemicals. [3]
Pathogenesis[edit | edit source]
The pathway of the disease can be split into two stages:
- Inflammation process in the vessel.
- Thrombosis through a secondary development of a thrombus
Symptoms[edit | edit source]
Symptoms associated with thrombophlebitis are the signs of inflammation (swelling of the body part, pain, skin redness, warmth) and tenderness of the vein. [1]
Diagnosis[edit | edit source]
Thrombophlebitis can be diagnosed based on a clinical examination. If the above-mentioned symptoms are visible/palpable, initial diagnostics can include the comparison of pulse palpation proximal and distal to the affected area. This test is positive if the pulse is barely or not at all detectable distal to the affected area. To ensure the diagnosis and to differentiate to a phlebothrombosis, an ultrasound can be used. [5]
Complications[edit | edit source]
Although thrombophlebitis has been considered a fairly benign disease, some research indicates that there is a correlation of a higher prevalence of deep vein thrombosis (phlebothrombosis) in patients with superficial thrombophlebitis. [1]
Prevention[edit | edit source]
During long car or plane trips, patients should be advised to stretch their legs frequently and drink plenty of liquids. Walking and exercises that increase blood circulation are effective measures to keep the blood flow steady. Wearing support hoses are often used as a prevention method for patients who are at a higher risk of developing thrombosis. In case of hospitalisation or as a prophylactic measure previous to surgery, subcutaneous injections of anticoagulants are most commonly prescribed. Routine changing and cleaning of intravenous (IV) lines help to prevent thrombophlebitis of the upper extremity.
Treatment[edit | edit source]
Treatment may depend on location, extent, symptoms, and underlying medical condition, but in general, it can be treated with:
- warm compresses
- elevation of the limb
- encouraging circulation (walking around)
- external compression with fitted stockings
- anti-inflammatory medication 
Recovery can take from a few weeks to a couple of months. [6]
Physical Therapy Treatment[edit | edit source]
---to be edited---
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg (Cochrane Review). Cochrane Database Syst Rev 2018;(2):CD004982.
- ↑ 2.0 2.1 Thrombophlebitis. Farlex Partner Medical Dictionary, 2012. Available from: https://medical-dictionary.thefreedictionary.com/thrombophlebitis (last accessed: 26.09.2020).
- ↑ 3.0 3.1 3.2 3.3 Di Nisio M, Peinemann F, Porreca E, Rutjes AWS. Treatment for superficial infusion thrombophlebitis of the upper extremity (Cochrane Review). Cochrane Database of Syst Rev 2015;(11):CD011015.
- ↑ Phlebothrombosis. Farlex Partner Medical Dicitionary, 2012. Available from: https://medical-dictionary.thefreedictionary.com/phlebothrombosis (last accessed: 26.09.2020).
- ↑ Schimmelpfennig J, Schwahn-Schreiber C, Marshall M. Aktuelle Standards der Diagnostik und Therapie der oberflächlichen Venenentzündung. Vasomed, 2013. Available from: https://www.der-niedergelassene-arzt.de/fileadmin/user_upload/zeitschriften/vasomed/Artikel_PDF/2013/3-2013/CME.pdf (last accessed: 26.09.2020).
- ↑ Vorvick L, Thrombophlebitis. Medline, 5 oct 2010.
