When there is swelling or redness with heat and pain of a vein, it is said to be phlebitis. There are two types of phlebitis, superficial phlebitis and deep vein thrombophlebitis. Superficial phlebitis is in a superficial vein on the exterior of the skin whereas deep vein thrombophlebitis happens when there is clotting of blood in the vein deep inside under the skin. Deep vein thrombophlebitis is dangerous to life as it can lead to damages to tissues of lungs.
Symptoms of Phlebitis
If phlebitis is very light then it might or might not show symptoms. Some of the symptoms of phlebitis are as follows:
- Redness of vein
- Swelling of vein
- Pain in the vein
- Tenderness in vein
- Fever, it could be low or high, in case it is high fever then it might mean infection in phlebitis’ vein.
- Also sometimes pus oozes out from spot of the thrombophlebitis which could also mean infection in phlebitis’ vein.
- There could be clear cords beside the vein which could be superficias thrombophlebitis or it could be a clot.
Causes of Phlebitis
The following are causes of phlebitis:
- Varicose vein
- Person who has been burnt
- Usage of drugs in veins
- Injuries or trauma to veins e.g. trauma or injuries to arms or legs leads to injuries to the veins beneath causing inflammation or phlebitis.
- Time period after surgeries, usually orthopedic surgeries
- When the system drainage of veins is disrupted due to removing of lymph nodes e.g. after being operated for breast cancer
- Extended immobility or inactivity: Blood which is stored in veins is pumped to the heart by the contraction of the lower leg muscles. If this is reduced or immobilized then the blood in veins becomes inactive which leads to clotting, ultimately resulting in thrombophlebitis.
- When catheters IV is inserted in veins which in turn induces phlebitis
- Primary disorder in clotting or cancer
- Smoking excessively along with the birth control tablets then there are high chances of thrombophlebitis.
- Obesity is also one of the major cause for thrombophlebitis.
Tests and Diagnosis of Phlebitis
In case of superficial phlebitis it can be diagnosed through physical examinations by a medical professional. When the area by the vein is red, tender, warm or swollen then there are high chances of phlebitis. For this an ultra sound of the particular part helps in diagnosing phlebitis.
Also blood test called D-dimer can help to diagnose phlebitis. It’s a chemical which is being sent out by blood clots as they begin to degrade. But with a normal D-dimer test diagnosing thrombophelitis is doubtful because it lacks in accuracy i.e. a D-dime level is also seen in pregnancy, surgeries etc.
Treatment varies as per the locations, symptom, extent and medical condition.
Superficial phlebitis can be treated as follows:
- To encourage walking
- By elevation of the involved extremity
- By taking proper oral anti inflammatory medicines such as ibuprofen, diclofenac
- Topical anti inflammatory medicines like diclofenac gel can also benefit
- By using warm compresses
- By applying external compression with fitted stocking
Thrombophlebitis can be treated as follows:
- If the cause is an intravenous catheter then its removal is advisable.
- In case of infection antibiotics have to be used.
- If the infection due to thrombophlebitis is serious then operations may have to be done.
In case of superficial phlebitis it may take few weeks to recover whereas in case of thrombophlebitis it may take weeks and months.
Evaluation of superficial phlebitis from deep vein thrombophlebitis can be done through ultrasound which involves saphenous veins. In case there are doubts of deep vein phlebitis then anti coagulation can be done. This is the thinning of blood. This is done through injecting heparin and after that oral anti coagulation i.e. warfarin is taken for about three to six months.
Some problems may occur due phlebitis like local infections, formation of abscess, clot formation and it may progress to a deep vein thrombosis and pulmonary embolism i.e. it can injure the lung tissues which is serious and could also be life threatening. In case of deep vein thrombophlebitis, if the leg veins are injured badly then it leads to post phlebitis syndrome. Post phlebitis syndrome is continual swelling of legs which causes leg pain, ulcer and discoloration.
Prevention of Phlebitis
To prevent phlebitis following precautions can be taken, they are:
- To stop smoking
- Good leg exercise when going on a long drive or traveling in plane
- Mobility soon subsequent to surgeries
- Maintaining hygiene and immediately removing intravenous catheters.
When phlebitis is recurring then compressive stockings are very good. Mostly for those who have less mobility are given a small dose of blood thinner i.e. heparin or enoxaparin which is injected for prevention of blood clot formation.
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