Causative & risk factors
Relative immobility can predispose to the formation of blood clots e.g. taking long flights or sitting in the same position for hours together.
Pregnant women and people with varicose veins have a much higher chance of developing thrombophlebitis. Getting an intravenous line in hospitals can also lead to thrombophlebitis. Increasing age, obesity and having a family history of thrombophlebitis are also risk factors for this condition. Use of oral contraceptive pills and smoking can also result in thrombophlebitis.
Clinical presentation
Superficial thrombophlebitis causes the affected vein and the overlying skin to become red, warm, swollen, tender and painful.
Deep vein thrombosis leads to pain and swelling in the affected part.
Sometimes, a blood clot may dislodge from its site of origin (embolism) and block an artery in the lung giving a rise to pulmonary embolism, a life-threatening condition.
Investigations
The patient’s symptoms and physical examination is adequate to raise the suspicion of thrombophlebitis. To confirm the diagnosis, the patient is asked to undergo a few blood and imaging tests. The blood is tested for a substance called D-dimer which is formed due to breakdown of blood clots.
Imaging tests such as ultrasound or venogram of the leg are carried out. In a venogram, dye is injected into the affected blood vessel and then X-ray images of the affected part are taken. Now venogram has been replaced by a non-invasive test known as Color Doppler.
Treatment
Treatment for mild thrombophlebitis is usually supportive consisting of hot fomentation, elevation of the affected part and painkillers. Some people may be required to wear stockings to reduce the swelling.
For patients with DVT, blood thinners or anti-clotting (thrombolytic) drugs are administered. Even antibiotics are recommended to prevent infection.
Severe cases may need surgery to excise the affected vessel or use a transplanted vessel to bypass the blood clot.
Another treatment option includes inserting a filter into a major abdominal vessel (vena cava) to prevent blood clots from lodging into the lungs.
Recent updates
A research study has demonstrated that the occurrence of superficial thrombophlebitis is much higher in summer months between May to October, compared to rest of the year.
