erlying deep vein thrombophlebitis.
On the other hand, deep vein thrombosis of the upper and lower extremities can be a more serious problem that can lead to a blood clot traveling to the blood vessels of the lungs and resulting in pulmonary embolism. Pulmonary embolism can injure lung tissue is serious and occasionally fatal.
Quick GuideSpider & Varicose Veins: Causes, Before and After Treatment Images
What causes phlebitis?
Phlebitis has many causes. Some of the common causes of phlebitis are:
- local trauma or injury to the vein
- prolonged inactivity, such as, long driving or plane rides
- insertion of intravenous catheters (IV) in hospitals, or IV induced phlebitis
- period after a surgery (post-operative period), especially orthopedic procedures
- prolonged immobility, as in hospitalized or bed-ridden patients
- varicose veins
- underlying cancers or clotting disorders
- disruption of normal venous system drainage because of removal of lymph nodes, for example, after mastectomy for breast cancer
- intravenous drug use
- patients with burns
What are the risk factors for phlebitis?
- One of the common risk factors for phlebitis is a trauma. For example, a trauma or an injury to the arm or leg can cause an injury the underlying vein resulting in inflammation or phlebitis.
- Prolonged immobility is another common risk factor for phlebitis. Blood that is stored in the veins of the lower extremities normally is pumped toward the heart by the contraction of the lower leg muscles. If the muscle contraction is limited due to prolonged (hours) immobility by sitting on a plane or a car, the blood in the veins can become stagnant and clot formation can result in thrombophlebitis.
- Hormone therapy (HT), birth control pills, and pregnancy all increase the risk for developing thrombophlebitis.
- Cigarette smoking is another risk factor for thrombophlebitis. Smoking in combination with birth control pills can substantially increase the risk of thromboembolism.
- Obesity is also a risk factor for thrombophlebitis.
- Certain cancers are known to increase the risk of clot formation (referred to as a hyper-coagulable state) by causing abnormalities in the normal clotting system (coagulation pathway). Some cancers with hypercoagulable state cause phlebitis or thrombophlebitis.
- Inherited (primary) or acquired (secondary) hypercoagulable states are associated with an increased risk of phlebitis and thrombosis. Some, but not all, of these states can be identified by appropriate laboratory testing.
- Recent surgery of any type can be associated with the conditions. The highest risk seems to come with major orthopedic procedures and procedures for cancers.
What are the symptoms of phlebitis?
Phlebitis, if mild, may or may not cause symptoms. Pain, tenderness, redness (erythema), and bulging of the vein are common symptoms of phlebitis. The redness and tenderness may follow the course of the vein under the skin.
Low grade fever may accompany superficial and deep phlebitis. High fever or drainage of pus from the site of thrombophlebitis may suggest an infection of the thrombophlebitis (referred to as septic thrombophlebitis).
Palpable cords along the course of the vein may be a sign of a superficial clot or superficial thrombophlebitis.
A deep venous thrombosis may present as redness and swelling of the involved limb with pain and tenderness. In the leg, this can cause difficulty walking.
How is phlebitis diagnosed?
The diagnosis of superficial phlebitis can be made based on the physical examination by a physician. Warmth, tenderness, redness, and swelling along the course of the vein is highly suggestive of superficial phlebitis or thrombophlebitis. An ultrasound of the area can help in making the diagnosis of phlebitis or excluding it.
Deep vein thrombosis is more difficult to diagnose on the basis of clinical examination. The strongest clinical indicator is unilateral extremity swelling, which may be associated with pain, warmth, redness, discoloration or other findings. The most commonly used imaging test for diagnosis of deep vein thr