American Medical Association Family Medical Guide - American Medical Association [359]
Women are slightly more likely to develop thrombophlebitis than men. The condition also occurs more frequently in people who have varicose veins (see page 602). In rare cases, people who are undergoing medical treatment that involves piercing the veins with needles (such as inserting an intravenous line) develop thrombophlebitis.
An untreated infection can lead to blood poisoning (see page 937). There is also a very slight chance that blood clots break off, travel through the bloodstream, and block a blood vessel. However, the most serious risk of thrombophlebitis is that the clot may travel to a more vulnerable spot, such as a deeper vein, most likely in the leg or pelvic area (see next article).
Symptoms
The main symptoms of thrombophlebitis are pain, redness, warmth, tenderness, itching, or swelling under the skin along the length of the affected vein. If the area is infected, you may also have a fever.
Diagnosis
A doctor can diagnose thrombophlebitis from a person’s symptoms and an examination of the affected area. Tests are usually not needed.
Treatment
If you have thrombophlebitis, your doctor may recommend that you take a nonsteroidal anti-inflammatory drug such as aspirin or ibuprofen to relieve pain and inflammation. If you have an infection, he or she may prescribe an antibiotic. The doctor may also recommend that you rest frequently, elevate the affected leg, and apply warm, moist compresses to the affected area. A nonprescription zinc oxide ointment can help relieve itching; ask your doctor to recommend one. The doctor also may recommend that you wear elastic support stockings. With treatment, thrombophlebitis usually clears up within a few weeks.
Deep Vein Thrombosis
Thrombosis is the formation of a blood clot (thrombus), which can partially or completely block a blood vessel. If a blood clot forms in a deeper vein, the condition is called deep vein thrombosis. Although deep vein thrombosis occurs most frequently in the legs and lower abdomen, it can occur anywhere in the body. The two main causes of deep vein thrombosis are injury to the lining of a vein and sluggish blood flow.
If you are older or are overweight or if you have injured your pelvis or a bone in your leg, you have an increased risk of deep vein thrombosis. The condition often develops during periods of immobility, especially while recovering from surgery or serious illness. Thrombosis also frequently occurs when an arm or leg is immobilized in a cast to stabilize a broken bone, or in the legs after a long trip on a plane or train. In these situations, blood flow tends to become sluggish. The disorder may also affect people whose blood clots more easily than normal, such as those who have a genetic defect in blood-clotting factors or a disease such as systemic lupus erythematosus (see page 920) or polycythemia (see page 627). Women over age 35 who smoke cigarettes and also take birth-control pills are at increased risk of thrombosis.
Symptoms
In deep vein thrombosis, the area drained by the vein, usually the calf or thigh, becomes swollen and painful as blood flow to it is obstructed. The pressure in the veins and capillaries in the leg increases, causing swelling. If the thrombosis is not in the leg, there may be no symptoms unless pieces of the clot break off, enter the bloodstream, and travel to the lungs, causing a pulmonary embolism (see next article). If the swelling is long-lasting, the skin may develop a brownish discoloration and may injure easily and develop frequent sores. If you have symptoms of deep vein thrombosis, see your doctor.
Diagnosis
Your doctor may order a Doppler ultrasound examination (see page 111) of the affected leg or a venogram, in which a contrast medium (dye) is injected into a vein in the foot and a series of X-rays of the affected leg is taken. The doctor also may recommend a radionuclide scan (see page 114) of the lungs to determine