Thrombophlebitis superficial
Superficial thrombophlebitis– an inflammatory disease characterized by the development of thrombosis and reactive spasm of the superficial veins, more often of the lower extremities. It often develops as a complication of varicose veins. Iatrogenic thrombophlebitis of the superficial veins sometimes occurs after venipuncture or venosection. Localization. The great saphenous vein and its tributaries in the upper third of the lower leg, lower and middle thirds of the thigh are most often affected. Classification. Acute, subacute and recurrent; ascending and descending. Etiology. Phlebitis can develop independently and cause venous thrombosis, or the infection quickly joins the primary thrombosis of the superficial veins. Pathogenesis. Thrombophlebitis develops in the presence of the following conditions: slowing of blood flow, increased blood clotting, damage to the wall or valves of the veins, infection.
Clinical picture
-
- Acute thrombophlebitis occurs suddenly, accompanied by an increase in body temperature with a preceding chill. Painful dense infiltrate in the form of a cord is palpated along the affected vein. Over the infiltrate, hyperemia of the skin with thickening of the subcutaneous tissue is possible. Enlarged regional lymph nodes
- The subacute form of thrombophlebitis proceeds without acute local inflammatory phenomena, at normal or in the first days of a non-cardinally elevated body temperature. When walking, moderate soreness, general malaise
- The recurrent form is characterized by the appearance of a new area of damage to the superficial veins or an exacerbation of a previously occurring process.
Laboratory research
-
- Leukocytosis with a shift of the leukocyte formula to the left and high ESR
- Increase in PTI. Differential Diagnosis
- Erysipelas
- Lymphangitis.
Treatment:
Conservative treatment
-
- Bed rest, elevated limb position
- Elastic bandaging contributes to the fixation of a blood clot in superficial veins
- Locally: compress with Vishnevsky ointment, semi-alcohol compress, heat
- Physiotherapy: iontophoresis with thrombolitin (trypsin-heparin complex)
- Medical treatment
- Anti-inflammatory therapy: acetylsalicylic acid, reopyrin, butadione
- Recurrent superficial thrombophlebitis – antibiotics
- Acetylsalicylic acid as a weak anticoagulant
- Troxevasin 0.3-0.6 / day for 2-4 weeks. Operative treatment. The Troyanov-Trendelenburg operation is performed in the presence of a thrombus at the mouth of the great saphenous vein (the thrombus is removed).
Complications
-
- Streptococcal lymphangitis
- TELA
- Thrombophlebitis of deep veins.
The prognosis is favorable with timely and adequate appropriate treatment. Synonym. Thrombophlebitis of superficial veins 180.0 Phlebitis and thrombophlebitis of the superficial vessels of the lower extremities