Thrombophlebitis (throm-boe-fluh-BY-tis) occurs when a blood clot blocks one or more of your veins, typically in your legs. Rarely, thrombophlebitis (sometimes called phlebitis) can affect veins in your arms or neck.
The affected vein may be near the surface of your skin, causing superficial thrombophlebitis, or deep within a muscle, causing deep vein thrombosis (DVT). Thrombophlebitis can be caused by trauma, surgery or prolonged inactivity. Superficial thrombophlebitis may occur in people with varicose veins.
A clot in a deep vein increases your risk of serious health problems, including the possibility of a dislodged clot (embolus) traveling to your lungs and blocking an artery there (pulmonary embolism). Deep vein thrombosis is usually treated with blood-thinning medications. Superficial thrombophlebitis is sometimes treated with blood-thinning medications, too.
Symptoms of the thrombophlebitis
Superficial thrombophlebitis symptoms include:
- Warmth, tenderness and pain in the affected area
- Redness and swelling
Deep vein thrombosis symptoms include:
When a vein close to the surface of your skin is affected, you may see a red, hard and tender cord just under the surface of your skin. When a deep vein in the leg is affected, your leg may become swollen, tender and painful.
Causes of appear of the thrombophlebitis
The cause of thrombophlebitis is a blood clot. Blood clots can be caused by many different things — namely anything that causes your blood not to circulate properly. It's possible a blood clot that causes thrombophlebitis could be caused by:
- An injury to a vein
- An inherited blood-clotting disorder
- Being immobile for long periods of time, such as during a hospital stay.
Your risk of thrombophlebitis increases if you:
- Are confined to bed for a prolonged time, such as after surgery, after a heart attack or after an injury, such as breaking your leg
- Have had a stroke that caused your arms or legs to be paralyzed
- Have a pacemaker or have a thin, flexible tube (catheter) in a central vein, for treatment of a medical condition, which may irritate the blood vessel wall and decrease blood flow
- Are pregnant or have just given birth, which may mean you have increased pressure in the veins of your pelvis and legs
- Use birth control pills or hormone replacement therapy, which may make your blood more likely to clot
- Have a family history of a blood-clotting disorder or a tendency to form blood clots easily
- Are inactive for a long period of time, such as from sitting in a car or an airplane
- Are older than 60
- Have varicose veins, which are a common cause of superficial thrombophlebitis
The more risk factors you have, the higher your risk of thrombophlebitis. If you have one or more risk factors, be sure to discuss prevention strategies with your doctor before long periods of inactivity, such as after an elective surgery or during a long flight or car ride.
If thrombophlebitis is in a vein just under your skin (superficial vein), complications are rare. However, if the clot occurs in a deep vein you may develop a serious medical condition known as deep vein thrombosis. If that happens, the risk of serious complications is greater. Complications may include:
- Pulmonary embolism. If part of a deep vein clot becomes dislodged, it may travel to your lungs, where it can block an artery (embolism) and cause a potentially life-threatening situation.
- Post-phlebetic syndrome. This condition, also known as post-thrombotic syndrome, can develop months or even years after you've had deep vein thrombosis. Post-phlebetic syndrome can cause lasting and possibly disabling pain, swelling and a feeling of heaviness in the affected leg. The use of compression stockings for two years or longer after deep vein thrombosis can help prevent or treat this condition.
Deep vein thrombosis also may damage valves in the veins in your legs. Veins have valves to prevent blood from flowing back as it is gradually pushed uphill toward your heart. When the valves in the veins of your legs don't work properly, several problems can occur:
- Varicose veins. The pooling of blood in your veins can cause them to balloon, resulting in varicose veins.
- Swelling. In some cases, the pooling may become so bad that your leg swells (edema).
- Skin discoloration. With chronic swelling and increased pressure on your skin, discoloration may occur. Sometimes, skin ulcers may develop. If you suspect a skin ulcer is forming, call your doctor.
Tests and diagnosis
To diagnose thrombophlebitis, your doctor will ask you about the discomfort you've had and then look for any affected veins near the surface of your skin. To determine whether you have superficial thrombophlebitis or deep vein thrombosis, your doctor may choose one of these tests:
- Blood test. Almost everyone with a blood clot has an elevated blood level of a naturally occurring, clot-dissolving substance called D dimer. But D dimer levels can be elevated in other conditions, too. So a test for D dimer isn't conclusive, but may indicate the need for further testing. It's also useful for ruling out deep vein thrombosis and for identifying people at risk of developing thrombophlebitis repeatedly.
- Ultrasound. A wand-like device (transducer) moved over the affected area of your leg sends sound waves into your leg. As the sound waves travel through your leg tissue and reflect back, a computer transforms the waves into a moving image on a video screen. A clot may be visible in the image.
- CT scan. Computerized tomography (CT) scan can provide visual images of your lungs and may show if a clot is present.