Thrombophlebitis
Thrombophlebitis is phlebitis (vein inflammation) related to a thrombus (blood clot).[1]When it occurs repeatedly in different locations, it is known as "Thrombophlebitis migrans" or "migrating thrombophlebitis". Thrombophlebitis (another medical term is "White Leg") is related to a thrombus in the vein. Risk factors include disorders related to increased tendency for blood clotting, injury to vein wall and reduced speed of blood in the veins such as varices and prolonged immobility. Prolonged traveling by car or airplane may promote a blood clot leading to thrombophlebitis but this occurs relatively rarely. Specific disorders associated with thrombophlebitis include superficial thrombophlebitis (affects veins near the skin surface) and deep venous thrombosis (affects deeper, larger veins). Thrombophlebitis migrans can be a non-metastatic manifestation of malignancies such as pancreatic carcinoma (Trousseau sign of malignancy).
For more specific recommendations, see the particular condition. In general, treatment may include the following:
o Presence of thrombus in inflamed blood vessels
o + Homan’s Sign – pain on the calf upon dorsiflexion
o Medical Management
§ Anticoagulant/ HEPARIN
· Does not cross the placental barrier
· Monitor APTT
· Antidote: PROTAMINE SULFATE
· No aspirin
For more specific recommendations, see the particular condition. In general, treatment may include the following:
- Medications
- analgesics (pain medications)
- anticoagulants e.g. warfarin or heparin to prevent new clot formation
- thrombolytics to dissolve an existing clot such as intravenous streptokinase.
- nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen to reduce pain and inflammation
- antibiotics (if infection is present) selection will usually depend with the causative agent.
- Support stockings and wraps to reduce discomfort
- Elevate the affected area to reduce swelling.
- Keep pressure off of the area to reduce pain and decrease the risk of further damage.
- Apply moist heat to reduce inflammation and pain.
- Surgical removal, stripping, or bypass of the vein is rarely needed but may be recommended in some situations.
o Presence of thrombus in inflamed blood vessels
o + Homan’s Sign – pain on the calf upon dorsiflexion
o Medical Management
§ Anticoagulant/ HEPARIN
· Does not cross the placental barrier
· Monitor APTT
· Antidote: PROTAMINE SULFATE
· No aspirin