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Superficial thrombophlebitis
From WikEM
(Redirected from Thrombophlebitis)
Contents
Background
Superficial thrombophlebitis is also known as "superficial venous thrombosis" and mainly involves symptomatic control. It is more likely in patients with varicose veins[1] Associated DVTusually only occurs at the junctions with deep venous system such as the groin[2]
Types[3]
- Sterile thrombophlebitis
- No infectious association
- Traumatic superficial thrombophlebitis
- Associated with limb injury from blunt trauma, IV catheters or chemical treatment
- Infection thrombophlebitis
- Associated with prolonged IVs and is the only thrombophlebitis to require antibiotics
- Migratory thrombophlebitis
- Recurrent in multiple differing sites and often associated with malignancies
Clinical Features
- Pain and discoloration to affected area
- Redness affected superficial vein
- Tender and hard vein on palpation
- Minimal limb swelling
Differential Diagnosis
The differential depends on the location of the thrombophlebitis.
Calf pain
- DVT
- Compartment syndrome
- Gastrocnemius strain
- Calcaneal bursitis
- Achilles tendon rupture
- Cellulitis
- Superficial thrombophlebitis
- Ruptured Popliteal cyst (Baker's)
Upper Extremity Pain
- Thoracic outlet obstruction/Pancoast tumor
- Lymphatic obstruction
- SVC Syndrome
- Cellulitis
- Necrotizing Fasciitis
- Superficial thrombophlebitis
Groin Pain
- DVT
- Hernia
- Cellulitis
- Superficial thrombophlebitis
- Acute pubalgia
Evaluation
- Diagnosis is purely clinical
- D-dimer has no clinical benefit and only consider DVTevaluation if there is significant limb swelling or location at a deep vein (popliteal/femoral vein)
Management
- NSAIDs for local pain
- Antibiotics are only needed if there is an associated cellulitis or obvious infection
- Little evidence for anticoagulation unless associated with a DVT[4]
Disposition
- Outpatient follow-up for evaluation of resolution of symptoms
See Also
External Links
References
- ↑ Leon L et al. Clinical significance of superficial vein thrombosis. Eur J Vasc Endovasc Surg 2005;29:10-17.
- ↑ Bergqvist D, Jaroszewski H. Deep vein thrombosis in patients with superficial thrombophlebitis of the leg. BMJ 1986;292:658-9.
- ↑ Nasr H, Scriven JM. Superficial thrombophlebitis (superficial venous thrombosis). BMJ. 2015;350:h2039. doi:10.1136/bmj.h2039.
- ↑ Di Nisio M, et al. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev 2013;4:CD004982.
