Phlebitis

June 2017


Definition


Phlebitis (also known as deep vein thrombosis) is a cardiovascular condition that corresponds to the complete obstruction of a vein, particularly in the lower limbs (90% of cases). It follows the formation of a blood clot in a vein, called a thrombus. Factors that increase the risk of generating phlebitis are numerous. These include, a prolonged immobilization of limbs, cancer, abnormal blood that is too viscous or that clots more easily due to coagulation disorders, certain diseases such as acute or chronic respiratory failure, pregnancy, or a recent surgery. The risk of blood clots increases with age, and having already had phlebitis is also a risk factor for recurrence. In the case of phlebitis, thrombus can sometimes migrate to the pulmonary circulation and cause a pulmonary embolism.

Symptoms


Depending on the location of the blockage, phlebitis may cause slightly different symptoms. Sometimes phlebitis doesn't show any clinical signs: it is said to be asymptomatic. In case of phlebitis in the calf, unilateral pain in one calf associated with increased heat and sometimes swelling are suggestive but inconsistent signs. Sometimes a slight fever is present. If phlebitis affects a higher part of the body, the pain may be localized to the thigh or groin.

Diagnosis


Clinical observation is rarely sufficient to establish a diagnosis of a phlebitis: we must then conduct a review of medical imaging called a Doppler ultrasound. This test can detect a clot in the venous system, as the Doppler is used to study blood flow in the venous system. Sometimes a measurement of D-dimer from a blood sample allows one to eliminate with certainty venous thrombosis. If no obvious cause is found for phlebitis, more blood tests are done in search of coagulation disorders.

Treatment


Phlebitis requires treatment with anticoagulants that will both limit risks of complications and allow for the disintegration of the clot. Initially, anticoagulants are given in the form of injections, then orally. Depending on the circumstances of the occurrence, the existence of a triggering factor may be identified or not. The duration of treatment will vary. Elevating the legs during bed rest and an early rise with wearing stockings is recommended. In very rare cases, surgical treatment may be prescribed.

Prevention


To avoid the occurrence of phlebitis, periods of extended bed rest should be avoided. If the latter is necessary, however, the legs should be raised, and compression bandages may possibly be used. In people the most at risk, a preventive treatment with anticoagulants may be needed.

Related

Original article published by . Translated by Jeff. Latest update on July 23, 2013 at 11:28 AM by Jeff.
This document, titled "Phlebitis," is available under the Creative Commons license. Any copy, reuse, or modification of the content should be sufficiently credited to CCM Health (health.ccm.net).