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Thrombophlebitis: Symptoms, diagnosis and treatment

What is thrombophlebitis?

Thrombophlebitis is inflammation or swelling in leg veins caused by blood clots.

Thrombophlebitis can be a complication of varicose veins and can look red, feel warm to the touch and can be painful.

With thrombophlebitis, a blocked vein in the leg becomes swollen, irritated, and even hard to the touch. Most cases involving the superficial leg veins begin to resolve by themselves in a week or two.  But, in rare occasions, these blocked veins can lead to infection and tissue damage from the loss of healthy circulation. 

When the deeper veins in the leg are involved, there are greater risks. A portion of the clot can break off and enter the bloodstream, travel far from the injury site and cause serious problems. If the clot reaches the heart or lungs and blocks circulation there, it can even cause death. In the more serious cases, people with thrombophlebitis need to be treated with drugs to "melt" the clot, lessen the swelling, and treat any infection that may develop.

What causes thrombophlebitis?

First, a blood clot forms, which can result from several causes - most commonly from blood not moving the way it should through the legs. You could be sitting down for a long time in a place where you cannot stretch out your legs, such as on a long drive or airline flight.  When blood sits still, it is more likely to form clots.  Clots can also occur during extensive bed rest following surgery. 

Varicose veins can also cause thrombophlebitis. The blood vessels are stretched out too much, allowing blood to pool in the vessel instead of streaming straight through in one direction, which can lead to blood clots.

People can also develop thrombophlebitis as a complication of intravenous tubes, or IVs.  Hospital staff try to lower this risk by changing the places where IV lines are placed in the body, but thrombophlebitis is still possible.  Pregnant women may also develop thrombophlebitis before or shortly after the baby is born.

Other risk factors include certain cancers, use of the hormone oestrogen for contraception or hormone replacement, and a family history of blood clots.

What are the symptoms of thrombophlebitis?

When this condition develops in a vein just under the skin, common symptoms include:

  • Red, swollen, irritated skin and tissue around the area, such as along an affected leg.
  • Painful, warm, tender, or hard sensations in the area.
  • Pain or tenderness which may increase when you put pressure on the affected area.
  • The swollen vein may feel like a tough "cord" under your skin.
  • Flexing your ankle may also be painful. 
  • Swollen foot, especially if only one side is swollen.

If you exhibit any of these symptoms, a doctor may take your pulse and blood pressure and arrange circulation tests to confirm that you have this condition.

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