Superficial Thrombophlebitis Follow-up

  • Author: Nelson S Menezes, MD, FRCS(Edin), FACS; Chief Editor: Vincent Lopez Rowe, MD   more...
 
Updated: Feb 27, 2009
 

Further Outpatient Care

Follow up in 2-3 days, either with an office visit or by telephone, to be sure the patient is progressing in a satisfactory manner.

Next

Complications

  • Extension into the deep venous system
  • Complications of suppurative phlebitis include the following:
    • Metastatic abscess formation
    • Septicemia
  • Hyperpigmentation over the affected vein
  • Persistent firm nodule in subcutaneous tissues at site of affected vein
Previous
Next

Prognosis

  • The prognosis is usually good.
  • Superficial phlebitis is rarely associated with pulmonary embolism, although it can occur, particularly if the process extends into a deep vein.
    • Individuals with superficial venous thrombosis do not seem to have a great tendency to develop deep venous thrombosis; however, duplex scanning may prove this assumption wrong.
    • Superficial venous thrombosis, on the other hand, does occur frequently in association with deep venous thrombosis, especially in patients with ulceration around the ankle.
  • The patient should be told to expect the disease process to persist for 3-4 weeks or longer. If it occurs in the lower extremity in association with varicose veins, it has a high likelihood of recurrence unless excision is performed.
Previous
Next

Patient Education

  • Because thrombophlebitis tends to recur if the vein has not been excised, instructing the patient in ways to prevent stasis in the vein is usually advisable.
    • The use of elastic stockings may be indicated, especially if the patient plans to stand in an upright position for long periods.
    • Slight elevation of the foot of the bed, avoidance of long periods of standing in an upright position, or inactivity is recommended.
  • For excellent patient education resources, visit eMedicine's Circulatory Problems Center. Also, see eMedicine's patient education articles Varicose Veins, Blood Clot in the Legs, and Phlebitis.
Previous
 
Contributor Information and Disclosures
Author

Nelson S Menezes, MD, FRCS(Edin), FACS  Assistant Professor of Surgery, Weill Cornell Medical College; Chief of Vascular Surgery, Department of Surgery, Brooklyn Hospital Center

Nelson S Menezes, MD, FRCS(Edin), FACS is a member of the following medical societies: American College of Surgeons, International Society of Endovascular Specialists, Medical Society of the State of New York, and Society for Vascular Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Jeffrey Lawrence Kaufman, MD  Associate Professor, Department of Surgery, Division of Vascular Surgery, Tufts University School of Medicine

Jeffrey Lawrence Kaufman, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Society for Artificial Internal Organs, Association for Academic Surgery, Association for Surgical Education, Massachusetts Medical Society, Phi Beta Kappa, and Society for Vascular Surgery

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Travis J Phifer, MD  Chief, Division of Vascular Surgery, Professor, Department of Surgery and Radiology, Louisiana State University Health Sciences Center in Shreveport

Travis J Phifer, MD is a member of the following medical societies: American College of Emergency Physicians, American College of Surgeons, American Medical Association, Association for Academic Surgery, Society for Academic Emergency Medicine, Society for Vascular Surgery, and Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Paolo Zamboni, MD  Professor of Surgery, Chief of Day Surgery Unit, Chair of Vascular Diseases Center, University of Ferrara, Italy

Paolo Zamboni, MD is a member of the following medical societies: American Venous Forum and New York Academy of Sciences

Disclosure: Nothing to disclose.

Chief Editor

Vincent Lopez Rowe, MD  Associate Professor of Surgery, Department of Surgery, Division of Vascular Surgery, University of Southern California Medical Center

Vincent Lopez Rowe, MD is a member of the following medical societies: American College of Surgeons, American Heart Association, Pacific Coast Surgical Association, Peripheral Vascular Surgery Society, Society for Clinical Vascular Surgery, Society for Vascular Surgery, and Western Vascular Surgical Society

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, William A. Marston, MD, to the development and writing of this article.

References

  1. McColl MD, Ramsay JE, Tait RC, et al. Superficial vein thrombosis: incidence in association with pregnancy and prevalence of thrombophilic defects. Thromb Haemost. Apr 1998;79(4):741-2. [Medline].

  2. Markovic MD, Lotina SI, Davidovic LB, et al. [Acute superficial thrombophlebitis--modern diagnosis and therapy]. Srp Arh Celok Lek. Sep-Oct 1997;125(9-10):261-6. [Medline].

  3. DeTakats G. "Resting Infection" in varicose veins, its diagnosis and treatment. Am J Med Sci. 1932;184:57.

  4. Altemeier WA, Hill EO, Fullen WD. Acute and recurrent thromboembolic disease: a new concept of etiology. Ann Surg. Oct 1969;170(4):547-58. [Medline].

  5. Sproul EE. Carcinoma and venous thrombosis: Frequency of association of carcinoma in body or tail of pancreas with multiple venous thrombosis. Am J Cancer. 1938;34:566.

  6. Buerger L. The veins in thromboangiitis obliterans: With particular reference to arteriovenous anastomosis as a cure for the condition. JAMA. 1909;52:1319.

  7. Shionoya S. Buerger's Disease: Pathology, Diagnosis and Treatment. Nagoya, Japan: University of Nagoya Press; 1990.

  8. Schonauer V, Kyrle PA, Weltermann A, et al. Superficial thrombophlebitis and risk for recurrent venous thromboembolism. J Vasc Surg. Apr 2003;37(4):834-8. [Medline].

  9. de Godoy JM, Braile DM. Protein s deficiency in repetitive superficial thrombophlebitis. Clin Appl Thromb Hemost. 2003;9:61-2.

  10. Lutter KS, Kerr TM, Roedersheimer LR, et al. Superficial thrombophlebitis diagnosed by duplex scanning. Surgery. Jul 1991;110(1):42-6. [Medline].

  11. Ascher E, Hanson JN, Salles-Cunha S, et al. Lesser saphenous vein thrombophlebitis: its natural history and implications for management. Vasc Endovascular Surg. Nov-Dec 2003;37(6):421-7. [Medline].

  12. Wichers IM, Di Nisio M, Buller HR, et al. Treatment of superficial vein thrombosis to prevent deep vein thrombosis and pulmonary embolism: a systematic review. Haematologica. May 2005;90(5):672-7. [Medline].

  13. Lozano FS, Almazan A. Low molecular weight heparin versus saphenofemoral disconnection for the treatment of above knee greater saphenous thrombophlebitis: a prospective study. Vasc Endovascular Surg. 2003;37:415-20.

  14. Bird V, Krasnokutsky S, Zhou HS, et al. Traumatic thrombophlebitis of the superficial dorsal vein of the penis: an occupational hazard. Am J Emerg Med. Jan 1997;15(1):67-9. [Medline].

  15. Blumenberg RM, Barton E, Gelfand ML, et al. Occult deep venous thrombosis complicating superficial thrombophlebitis. J Vasc Surg. Feb 1998;27(2):338-43. [Medline].

  16. Brook I, Frazier EH. Aerobic and anaerobic microbiology of superficial suppurative thrombophlebitis. Arch Surg. Jan 1996;131(1):95-7. [Medline].

  17. Cranley JJ. Thrombophlebitis in obstetrics and gynecology. In: Rakel RE, ed. Conn's Current Therapy. Philadelphia, Pa: WB Saunders; 1984.

  18. Glasser ST. Principles of Peripheral Vascular Surgery. Philadelphia, Pa: FA Davis; 1959.

  19. Górski G, Szopinski P, Michalak J, et al. Liposomal heparin spray: a new formula in adjunctive treatment of superficial venous thrombosis. Angiology. Jan-Feb 2005;56(1):9-17. [Medline].

  20. Johnson G, DePalma RG. Superficial thrombophlebitis: diagnosis and management. In: Rutherford's Vascular Surgery. Vol 1. 5th ed. Philadelphia, Pa: WB Saunders; 1998:1979, section XIX.

  21. Marchiori A, Verlato F, Sabbion P, et al. High versus low doses of unfractionated heparin for the treatment of superficial thrombophlebitis of the leg. A prospective, controlled, randomized study. Haematologica. May 2002;87(5):523-7. [Medline].

  22. Murray CK, Beckius ML, McAllister K. Fusarium proliferatum superficial suppurative thrombophlebitis. Mil Med. May 2003;168(5):426-7. [Medline].

  23. Neher JO, Safranek S, Greenwald JL. Clinical inquiries. What is the best therapy for superficial thrombophlebitis?. J Fam Pract. Jul 2004;53(7):583-5. [Medline].

  24. Prandoni P, Tormene D, Pesavento R,. High vs. low doses of low-molecular-weight heparin for the treatment of superficial vein thrombosis of the legs: a double-blind, randomized trial. J Thromb Haemost. Jun 2005;3(6):1152-7. [Medline].

  25. Quenet S, Laporte S, Décousus H, et al. Factors predictive of venous thrombotic complications in patients with isolated superficial vein thrombosis. J Vasc Surg. Nov 2003;38(5):944-9. [Medline].

  26. Rush MD, Schoenfeld CN, Watson WA, et al. Skin necrosis and venous thrombosis from subcutaneous injection of charcoal lighter fluid (naptha). Am J Emerg Med. Sep 1998;16(5):508-11. [Medline].

  27. Superficial Thrombophlebitis Treated by Enoxaparin Study Group. A pilot randomized double-blind comparison of a low-molecular-weight heparin, a nonsteroidal anti-inflammatory agent, and placebo in the treatment of superficial vein thrombosis. Arch Intern Med. Jul 28 2003;163(14):1657-63. [Medline].

  28. Wester JP, Kuenen BC, Meuwissen OJ, et al. Mondor's disease as first thrombotic event in hereditary protein C deficiency and anticardiolipin antibodies. Neth J Med. Feb 1997;50(2):85-7. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.