Phlebitis

Thrombophlebitis is swelling (inflammation) of a vein caused by a blood clot.

Causes, incidence, and risk factors

Sitting for a long period of time (such as on a long airplane trip) increases a person's risk of thrombophlebitis.

Disorders that increase a person's chance for blood clots also lead to thrombophlebitis. The two main types of thrombophlebitis are superficial thrombophlebitis (affects veins near the skin surface) and deep venous thrombosis (affects deeper, larger veins).

Symptoms

The following symptoms are often associated with thrombophlebitis:

Signs and tests
 * Warmth and tenderness over the vein
 * Pain in the part of the body affected
 * Skin redness (not always present)
 * Inflammation (swelling) in the part of the body affected

The health care provider makes the diagnosis primarily based on how the affected area looks. The patient may need to have pulse, blood pressure, temperature, skin condition, and circulation frequently checked to monitor for complications.

If the cause is not easily identifiable, one or more of the following tests may be performed to determine the cause:

Treatment
 * Doppler ultrasound
 * Venography
 * Blood coagulation studies

In general, treatment may include support stockings and wraps to reduce discomfort as well as medications, such as:

The patient may be told to do the following:
 * Analgesics (pain medications)
 * Anticoagulants (blood thinners) to prevent new clots from forming
 * Thrombolytics to dissolve an existing clot
 * Nonsteroidal anti-inflammatory medications (NSAIDS) such as ibuprofen to reduce pain and inflammation
 * Antibiotics (if infection is present)

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

For more specific recommendations, see the particular condition (superficial thrombophlebitis or deep venous thrombosis).

Expectations (prognosis)

Thrombophlebitis and other forms of phlebitis usually respond to prompt medical treatment.

Complications

Superficial thrombophlebitis rarely causes complications. However, there is a high risk of complications when the clot if in a deeper vein (deep vein thrombosis). Complications of deep vein thrombosis include blood clots in the lungs (pulmonary embolism), heart attack, and stroke.

Calling your health care provider

Call your health care provider if you have symptoms of thrombophlebitis.

Call your health care provider promptly if thrombophlebitis symptoms do not improve with treatment, if symptoms get worse, or if new symptoms occur (such as an entire limb becoming pale, cold, or swollen).

Prevention

Routine changing of intravenous (IV) lines helps to prevent thrombophlebitis related to IV lines.

If you are taking a long car or plane trip, walk or stretch your legs once in a while and drink plenty of liquids.