Treatment for phlebitis in the leg: Thrombophlebitis – Diagnosis and treatment
What is phlebitis, and what’s the best treatment? : Vascular Solutions: Vein Specialists
VEINS CHARLOTTE BLOG
WHAT IS PHLEBITIS?
Phlebitis, or inflammation of a vein, is a condition where a leg vein and surrounding tissues have become irritated, red, warm, and tender. In an area of phlebitis, the skin can feel as if there are knots or lumps underneath the skin surface.
Phlebitis can occur in superficial veins (close to the skin surface) or deep veins (in the central portion of the leg). Phlebitis affecting the superficial veins is less concerning than phlebitis affecting the deep veins.
If phlebitis occurs in a superficial vein (ie. close to the skin) the overlying skin will commonly be warm and sensitive to light touch. A common pathway for developing phlebitis is when a clot develops in a varicose vein, just underneath the skin surface.
Symptoms of phlebitis are caused by inflammation, which represents the body’s response to injury or tissue damage.
Phlebitis can be triggered by excessive stretching of the leg veins. This situation is commonly encountered in people with varicose veins, where the veins have become abnormally engorged and dilated.
Another situation where phlebitis can occur is when a blood clot has developed in a vein. The presence of blood clot triggers an inflammatory response, which causes pain and tenderness.
When phlebitis occurs is in conjunction with superficial blood the medical term for this condition is “superficial venous thrombophlebitis,” commonly simply abbreviated as “thrombophlebitis”
When a blood clot occurs in a deep vein the term deep vein thrombosis (DVT) more accurately describes the condition and is the preferred terminology.
WHAT ARE THE SYMPTOMS OF PHLEBITIS?
When phlebitis affects superficial veins common symptoms include pain, tenderness, reddish skin discoloration, and warmth/heat arising from the skin. The most commonly affected area is the calf, but it’s also common for symptoms to occur just above the ankle or on the thigh.
Symptoms of phlebitis affecting the deep veins include aching pain, throbbing, leg heaviness, and leg swelling. Sometimes deep vein thrombosis can occur without significant pain. In this situation, leg/ankle swelling may be the only sign of a deep vein blood clot.
The severity of symptoms due to phlebitis is variable. Most often symptoms are mild-moderate, but sometimes the pain can be severe. Quite often symptoms start to build up over 24-48 hours. Most people who get phlebitis cannot recall a specific triggering injury or event.
Risk factors for phlebitis include being sedentary for long periods (eg. long plane flight or car ride), obesity, smoking, estrogen-containing medications (including oral contraceptives and hormone replacement therapy), clotting disorders (which may predispose to easy clotting), and externally visible varicose veins. Other risk factors include trauma to a varicose vein (eg. if your leg bumps against the dishwasher), and cancer (which can increase the risk of developing blood clots).
WHAT ELSE COULD IT BE?
Several medical conditions mimic phlebitis. Probably the most common condition that mimics phlebitis is cellulitis, a bacterial infection of the skin. Several other dermatologic and auto-immune conditions can mimic phlebitis.
HOW IS PHLEBITIS DIAGNOSED?
The diagnosis of phlebitis is based on symptoms and examination findings, supplemented by diagnostic imaging. The most common imaging study used to support the diagnosis of phlebitis is venous ultrasound.
The optimal treatment of phlebitis varies on several factors. If phlebitis is localized to a small section of a superficial vein then warm compresses, oral anti-inflammatory medications (eg. Motrin), topical anti-inflammatory creams (eg. Arnica), and leg elevation may be all that’s required.
If you have a superficial clot (superficial thrombophlebitis) that’s close to a connection with a deep vein, you may require blood thinners.
If a blood clot is identified in a deep vein (deep vein thrombosis – DVT) you’ll likely need to start on a blood-thinner, unless there’s a contraindication.
If you think you might have phlebitis, it’s important to seek medical attention. You’ll probably need a vein ultrasound to diagnose what’s going on. Other management recommendations will be guided by the assessment of your medical provider.
A high percentage of patients with superficial phlebitis have an associated condition known as venous reflux. This is a condition where the valves in the leg veins have ceased to function effectively. If venous reflux is present procedures can be performed to treat the underlying problem.
Commonly performed vein procedures include such as radiofrequency ablation (ClosureFast procedure), VenaSeal closure system, Varithena microfoam, Clarivein, and endovenous laser therapy (EVLT). These procedures seal closed the bad veins that creating the environment in which superficial phlebitis can occur. Vein procedures are usually performed in a staged fashion after the flare-up of superficial phlebitis has abated.
Vascular Solutions is the leading vein clinic for varicose veins treatment in Charlotte, NC. We use the latest technology and get the best results. Our vein specialists are the best in the Carolinas. If you believe you have phlebitis contact our office now to set up your new patient consultation.
VEINS CHARLOTTE BLOG – SOLUTION SOLVED
Peter Ford MD FACS RPVI
Peter Ford, MD, FACS, RPVI, is a board certified vascular surgeon who works at Vascular Solutions in Charlotte, North Carolina. Dr. Ford specializes in the management of varicose veins and venous disease.
Phlebitis (superficial thrombophlebitis) – NHS
Phlebitis means “inflammation of a vein”.
The vein becomes inflamed because there’s blood clotting inside it or the vein walls are damaged.
Superficial thrombophlebitis is the term for an inflamed vein near the surface of the skin (usually a varicose vein) caused by a blood clot.
Symptoms of phlebitis
Symptoms of superficial thrombophlebitis include:
- painful hard lumps underneath the skin
- redness of the skin
This is usually on the lower leg, although it can occasionally affect surface veins in the arms, penis or breast.
Is phlebitis serious?
Superficial thrombophlebitis in a leg is not usually serious.
The blood clot usually clears and the inflammation dies down within a few weeks.
Most people with superficial thrombophlebitis are otherwise well.
There should not be any foul discharge or abscess, and it’s normally just lumps under the skin rather than swelling of the whole calf.
This may be painful, but it should not prevent you walking normally.
You’re more at risk of superficial thrombophlebitis if you:
- have varicose veins
- are very overweight
- take the contraceptive pill or HRT (although these only slightly increase your risk of blood clots)
- are pregnant
- have had a previous blood clot or another problem with the vein
- have recently had injections or a drip put into the vein
- have a condition that causes the blood to clot more easily, such as thrombophilia, inflammation of the smaller arteries (polyarteritis) or a high concentration of red blood cells in your blood (polycythaemia)
- have cancer
Treatments for phlebitis
Phlebitis is inflammation, not infection, so antibiotics are not helpful.
You can follow this advice to help reduce any pain and swelling:
- raise the leg to help reduce swelling
- ask your doctor if compression stockings would be suitable for you to help reduce swelling
- keep active to keep the blood circulating
- press a cold flannel over the vein to ease any pain
- take painkillers or anti-inflammatory medicine like ibuprofen – but if you’ve been prescribed anticoagulant (blood-thinning) medicine, do not take aspirin or ibuprofen unless advised to by your doctor
- rub an anti-inflammatory cream or gel on the area if the affected area is only small
When the inflammation settles, you may be left with darkened skin and the lump may take 3 or 4 months to go. But most people make a full recovery.
If the thrombophlebitis was in a varicose vein, it’s likely that the varicose veins will keep coming back, possibly with further episodes of thrombophlebitis.
This is because there’s a basic problem with the vein and you may need this removed.
Find out more about how varicose veins are treated
Risk of deep vein thrombosis
There’s a small chance of the blood clot travelling along the vein to where it meets a deeper vein and a deep vein thrombosis (DVT) developing.
This is more likely if the surface clot extends into the upper thigh or groin, or behind the knee (in places where superficial veins meet deeper veins).
It’s also more likely to happen if:
- the affected vein is a normal vein rather than a varicose vein
- you have had a DVT before
- you’re immobile
A DVT can cause pain, swelling and a heavy ache in your leg. See a GP immediately if you experience these symptoms.
Find out more about DVTs
Page last reviewed: 01 May 2019
Next review due: 01 May 2022
Superficial Thrombophlebitis: Symptoms, Causes
What is phlebitis?
Phlebitis is a term used to describe veins that are painful, red and inflamed.
What is thrombophlebitis?
Thrombophlebitis means there is a blood clot in the vein (thrombosis or thromboembolism) that causes swelling and pain.
Superficial thrombophlebitis: If the vein that has the clot is just under the skin, it is called a superficial venous thrombosis or superficial thrombophlebitis. This type of clot does not usually travel to the lungs unless it reaches the deep veins. But, superficial thrombophlebitis can be painful and treatment may be needed.
Deep vein thrombosis (DVT): If the blood clot is in the veins deep in the body, it is called a deep vein thrombosis (DVT). This type of clot can travel to the lungs (pulmonary embolism) and block blood flow to the lungs. In severe cases, this can lead to death. Most DVTs require treatment right away.
Symptoms and Causes
What causes superficial thrombophlebitis?
Superficial thrombophlebitis can be caused by an injury to the arm or leg; having an intravenous (IV) line; or the cause may not be known. Potential risk factors are the same as for those who have deep vein thrombosis (DVT), and include:
- An inherited (family) condition that increases your risk of blood clots
- Cancer and some cancer treatments (chemotherapy)
- Limited blood flow because of an injury, surgery, or not moving
- Long periods of inactivity that decrease blood flow, such as:
- Sitting for a long time, such as in a car, truck, bus, train or airplane
- After surgery or a serious injury
- Pregnancy and the first 6 weeks after giving birth
- Being over age 40 (although clots can form at any age)
- Being overweight
- Taking birth control pills or hormone therapy, including for treatment for postmenopausal symptoms
- Placement of a central venous catheter or pacemaker
What are the symptoms of thrombophlebitis?
- Swelling of the leg or arm (sometimes this happens suddenly)
- Pain or tenderness in the area of the clot
- Feeling of increased warmth in the area of the clot
- Red or discolored skin in the area of the clot
If thrombophlebitis causes pain or interferes with your daily activities, talk to your doctor about treatment options.
Diagnosis and Tests
How is superficial thrombophlebitis diagnosed?
Your doctor may suspect that you have superficial thrombophlebitis based on a physical exam. But, a vascular ultrasound is needed to confirm the diagnosis. An ultrasound is also important because about 20% of people with superficial thrombophlebitis also have a DVT.
Many times, patients who have superficial thrombophlebitis wait to see a doctor, thinking they have a muscle strain or sprain. In fact, without an ultrasound, the doctor may also think the problem is related to a muscle.
Management and Treatment
What are the treatment options for patients with superficial thrombophlebitis?
The main goal when you begin treatment for superficial thrombophlebitis is to control pain and inflammation.
- Nonsteroidal anti-inflammatory pain medication (NSAIDs) such as ibuprofen
- Warm compresses
For inflammation and swelling:
- Leg elevation when you are resting
- Compression stockings
- Staying active and not sitting for too long
Other medical treatments:
Most times, treatment for patients with superficial thrombophlebitis includes only ways to manage pain and inflammation. But, if you are at risk of developing a DVT or have problems that affect the way your blood clots, you will likely need to take anticoagulation medication.
In most cases, superficial thrombophlebitis clears up within a few weeks.
When is surgery necessary for phlebitis?
If you have superficial thrombophlebitis and varicose veins, your doctor may talk to you about surgical treatment. The combination of these conditions puts you at greater risk of having superficial thrombophlebitis after the condition clears up. The best way to reduce this risk is to use surgery or endovenous therapy to take care of the varicose veins and keep them from returning. These procedures are performed by a vascular specialist in either the hospital or an outpatient surgery center.
Types of surgery include:
Endovenous ablation. A special catheter (long, thin tube) is placed in the saphenous vein (the longest vein in your body; it runs along the inside of your leg). The catheter is inserted by making a small puncture in your calf. Once it is in place, electric currents (radiofrequency) or laser energy is sent through the catheter to the area of the vein. This stops the backward blood flow in the vein that leads to varicose veins. Your doctor may also combine this procedure with another to remove large varicose veins through very small incisions (ambulatory phlebectomy).
Endovenous ablation is a less painful and less invasive alternative to surgical ligation and stripping, which is rarely used anymore.
Sclerotherapy. A solution is injected directly into the affected vein. The solution irritates the lining of the vessel, causing it to swell and stick together. Over time, the vessel turns into scar tissue that fades from view. This treatment is performed in the office by a vascular specialist or surgeon. It does not involve a hospital stay. Many times, the doctor will perform sclerotherapy along with endovenous ablation to take care of all varicose veins in the leg.
Your healthcare provider will talk to you about the best treatment for you.
Doctors vary in quality due to differences in training and experience; hospitals differ in the number of services available. The more complex your medical problem, the greater these differences in quality become and the more they matter.
Clearly, the doctor and hospital that you choose for complex, specialized medical care will have a direct impact on how well you do. To help you make this choice, please review our Miller Family Heart, Vascular & Thoracic Institute Outcomes.
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Choosing a doctor to treat your vascular disease depends on where you are in your diagnosis and treatment. The following Heart, Vascular & Thoracic Institute Sections and Departments treat patients with all types of vascular disease, including blood clotting disorders:
Section of Vascular Medicine: for evaluation, medical management or interventional procedures to treat vascular disease. In addition, the Non-Invasive Laboratory includes state-of-the art computerized imaging equipment to assist in diagnosing vascular disease, without added discomfort to the patient. Call Vascular Medicine Appointments, toll-free 800-223-2273, extension 44420 or request an appointment online.
Department of Vascular Surgery: surgery evaluation for surgical treatment of vascular disease, including aorta, peripheral artery, and venous disease. Call Vascular Surgery Appointments, toll-free 800-223-2273, extension 44508 or request an appointment online.
You may also use our MyConsult second opinion consultation using the Internet.
The Heart, Vascular & Thoracic Institute also has specialized centers and clinics to treat certain populations of patients:
Learn more about experts who specialize in the diagnosis and treatment of vascular and arterial disease.
If you need more information,click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
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Superficial Thrombophlebitis | Causes and Treatment
Superficial thrombophlebitis is inflammation of a vein just under the skin, usually in the leg. A small blood clot also commonly forms in the vein, but is usually not serious. The condition usually settles and goes within 2-6 weeks. Treatments can ease pain or discomfort.
Superficial thrombophlebitis is different to, and much less serious than, deep vein thrombosis (DVT). However, in a small number of cases, complications can occur with superficial thrombophlebitis, including extension of the blood clot further up the vein. If the clot extends to where the superficial and deep, larger veins join, a DVT can develop.
What is superficial thrombophlebitis?
The superficial veins are the ones that you can often see or feel just under the skin. Most bouts of superficial thrombophlebitis occur in a leg vein. However, any superficial vein can be affected. A typical site is in a varicose vein in a leg. Varicose veins are common, particularly in pregnant women. Superficial thrombophlebitis is not usually serious but complications can sometimes occur (see below).
What is thrombophlebitis?
- Phlebitis means inflammation of a vein.
- Thrombo(sis) means a blood clot in a vein.
A vein is a blood vessel that takes blood towards the heart. If a vein becomes inflamed, a blood clot commonly forms inside the inflamed portion. So, the term thrombophlebitis is used to mean an inflamed vein, with or without a small blood clot inside the vein. Thrombophlebitis is commonly just called phlebitis.
Note: this leaflet does not deal with inflammation or thrombosis of deep veins. The deep veins are larger, pass through the muscles in your arms and legs and you cannot see or feel them. Some people get confused between superficial thrombophlebitis and deep vein thrombosis (DVT). They are quite different. A DVT is more serious.
See the separate leaflet called Deep Vein Thrombosis for more detail.
What causes superficial thrombophlebitis?
Many cases occur for no apparent reason. A slight injury to the vein may trigger the inflammation in some cases.
There are a number of risk factors that make it more likely for inflammation to develop in a vein:
- Varicose veins – many cases occur in people who have varicose veins of the legs. Varicose veins are prone to minor injuries which can lead to inflammation.
- Intravenous injection or cannulation – sometimes it occurs after having injections into the veins (intravenous injections) or ‘drips’ (intravenous infusions) in hospital. These are commonly given in hand or arm veins. Such procedures can injure the vein and may trigger inflammation. Damage to the veins in this way is also common in people who inject ‘street drugs’.
- Previous problems with veins – if someone has had previous superficial thrombophlebitis or a previous DVT, they are more likely to get superficial thrombophlebitis.
- Abnormalities of blood clotting factors – various conditions can alter certain chemicals (clotting factors) in the bloodstream, which make the blood clot more easily. These include using the oral contraceptive pill, using hormone replacement therapy, cancer, smoking and pregnancy. There are also some less common hereditary blood disorders where blood clots develop more readily than usual.
- Blood flowing more slowly than normal (stasis) – this might occur in veins that are varicose, during long flights or in people who are immobile, and also following major surgery.
What are the symptoms of superficial thrombophlebitis?
Swelling, redness and tenderness along a part of the vein are the usual symptoms. You may develop a high temperature (fever). If a blood clot develops inside the inflamed part of the vein, the vein may then feel hard or knobbly. The blood clot is usually of little concern, as it is small. There are other veins which carry the blood and bypass the blocked vein.
When the inflammation settles, a persistent darker area of skin (hyperpigmentation) may remain over the affected vein. A small firm lump may also persist below the skin. This may be tender to the touch for some time.
Do I need any investigations?
Your doctor is usually able to diagnose superficial thrombophlebitis by talking to you and examining the affected area. Investigations are not usually needed, especially if you have one of the risk factors for superficial thrombophlebitis (see above). However, if your doctor is concerned that you may have a DVT (see below), they may advise that you have some tests to exclude this. This usually means a special ultrasound scan of the affected area to look for any clots in the deep veins.
If you have recurrent bouts of thrombophlebitis, especially if you have no real risk factors for superficial thrombophlebitis, your doctor may suggest some tests to check that you do not have any problems with the clotting of your blood. They may also suggest other tests to look for more rare causes of recurrent superficial thrombophlebitis (see below).
What is the treatment for superficial thrombophlebitis?
Most bouts of superficial thrombophlebitis last for 3-4 weeks. If they are associated with varicose veins, they are likely to return (recur). No treatment may be needed if the symptoms are mild. One or more of the following treatments may be advised, depending on your symptoms and the severity of the condition:
- Keep active. Try to keep up your normal activities. This should be possible unless the pain is severe.
- A hot cloth (flannel) placed over the vein. This may ease the pain.
- Painkilling tablets. Anti-inflammatory painkillers such as ibuprofen may ease the pain (but are not advised if you are pregnant). Paracetamol is an alternative. Some people may not be able to take anti-inflammatory painkillers. Check with your doctor or pharmacist. Always read the packet leaflet that explains possible side-effects. There is also some evidence that anti-inflammatory tablets may reduce the risk of superficial thrombophlebitis enlarging or extending within a vein and/or it coming back. However, more studies are needed to confirm this.
- Anti-inflammatory creams or gels. An example is ibuprofen gel. These are an alternative if superficial thrombophlebitis is mild and only affects a small area of vein. They tend to produce fewer side-effects than those taken by mouth.
- Hirudoid® cream (heparinoid) may improve your symptoms, although there is some evidence that heparin gel may be more effective.
- Fondaparinux (also called Arixtra®) is an injected medicine which inhibits one of the body’s clotting factors. When given for six weeks it reduces the risk of DVT and of extension and recurrence of thrombophlebitis.
- Raising the affected leg. When you rest (when watching TV, or reading a book, etc), if you raise an affected leg so that your foot is higher than your hip, it helps to reduce swelling and discomfort. You can do this by lying on a sofa and putting the leg up on some cushions. When sleeping in bed, you can keep your leg raised by putting it on a pillow.
- Compression (support) stockings. These may be advised by your doctor if a vein in your leg is affected. They may ease discomfort and reduce swelling whilst the inflammation settles.
If your doctor feels that you may have a DVT or be at high risk of developing one, they may suggest that you be referred either to the hospital or to a special DVT clinic. This will enable you to have any investigations or treatment necessary (see above). Sometimes, ‘just in case’ (prophylactic) treatment may be given to people who have superficial thrombophlebitis and may be at high risk of developing a DVT. This involves injection of a medicine to thin the blood.
Are there any complications from superficial thrombophlebitis?
The inflammation and pain usually settle within a few weeks. Most people make a full recovery. The possible complications listed below are uncommon. They are listed, however, to give guidance on what to look out for. See a doctor as soon as possible if you suspect that a complication is developing.
Sometimes the affected vein becomes infected. The pain may then become worse and the redness spreads. You are likely to feel generally unwell. Infection is more common in someone who has had a drip inserted for a long period of time, in people who abuse ‘street drugs’ or in people with a weakened immune system. Antibiotics are needed to treat the infection. If the infection is severe, you may need to be admitted to hospital for antibiotics (given directly into a vein). Rarely, infection in a vein becomes severe and may spread to other areas of the body.
Blood clot extension
In some cases, the blood clot can extend further up the vein. If the clot extends to where the superficial and deep veins join, a DVT can develop. This is more likely if the superficial thrombophlebitis is in the upper thigh or the groin, near to where the superficial veins and the deep veins of the leg meet. There is a similar meeting point of superficial and deep veins at the crease behind the knee. It is also more likely to occur:
- If superficial thrombophlebitis develops in a previously normal vein (not a varicose vein).
- If you have had a DVT before.
- If you are immobile for some reason.
See a doctor urgently if:
- Inflammation, redness, or hardness spreads up your inner thigh towards your groin or is around the back of your knee or calf.
- Your whole leg swells.
- Pain becomes suddenly worse.
- You develop any new breathing problems, or develop chest pains. Sometimes a clot from a DVT breaks off and travels to the lung.
When thrombophlebitis leads to a DVT, there is an increased risk of developing further DVTs and possibly clots on the lung (pulmonary embolism).
Recurrent superficial thrombophlebitis
It is common for people with varicose veins to have repeated (recurrent) bouts of superficial thrombophlebitis. However, for a small number of people this may be the first sign of a more serious condition. For example, cancer or a rare condition called polyarteritis nodosa in which there is patchy inflammation of the walls of the arteries. This is more likely if the bouts occur at different sites, or in different veins in someone without varicose veins.
Tests may be advised if there is no obvious explanation for recurring bouts of superficial thrombophlebitis.
What is the Best Treatment for Phlebitis?
Phlebitis is a type of vein disease where your vein become inflamed. This inflammation can cause swelling and pain. The area may also feel tender, itchy, and warm. It may throb or burn as well.
When a thrombus or blood clot causes the inflammation, it’s referred to as thrombophlebitis, and typically occurs in the veins of the leg. Vein treatments for phlebitis can help.
Phlebitis can be in the skin (superficial) or deep beneath the skin in the tissues or veins (deep vein thrombophlebitis, deep vein thrombosis or DVT). Complications from a surgical or medical procedure can lead to superficial phlebitis.
Factors that could lead to thrombophlebitis include:
Staying in bed for many hours.
Being on a long airplane flight.
Sitting for long periods of time.
Having varicose veins.
Incurring anInjury to the legs or arms.
Being on birth control pills
Being on hormone replacement therapy (HRT).
Having a condition that increases the risk of blood clots.
If you notice any signs of pain, swelling and inflamed superficial veins on your legs, call your doctor. DVT requires immediate medical care.
Treatment for Phlebitis
The treatment option that will be best for you will depend various factions, including how severe your phlebitis is and how chronic. When venous reflux causes superficial phlebitis or other underlying causes, treatment typically starts with simple conservative measures you can do at home.
Home treatment for phlebitis may include:
Taking an anti-inflammatory medicine like Ibuprofen.
Applying a warm compress to the area affected.
Leg compression stockings to improve blood flow and relieve swelling and pain. These also reduce your risk of DVT.
To treat superficial phlebitis, doctors may prescribe certain medications like diclofenac (Cataflam, Voltaren, etc. ) or suggest ibuprofen. They may also prescribe you a topical anti-inflammatory medication like diclofenac gel.
If the doctor diagnoses deep venous thrombophlebitis or suspects there’s a chance it will develop, they may prescribe anti-coagulation medications (blood thinning). Usually, this is done by injection of fondaparinux (Arixtra) or low molecular weight heparin (Lovenox).
They’ll prescribe antibiotics if you have signs of infection.
If venous reflux is the underlying cause, you may receive Endovenous Laser Treatment.
If it’s varicose veins causing recurrent thrombophlebitis or pain, you might require certain vein treatments like varicose vein stripping. With this procedure, the doctor removes your varicose veins surgically through small incisions.
Being active is the best way of preventing phlebitis. Engage in daily physical activity and exercise like swimming, walking, jogging, dance classes or cycling. Avoid sitting or lying down for prolonged periods. If you’ve been put on bed rest, wear compression stockings.
What is vein inflammation (phlebitis)? Symptoms – treatment
What is vein inflammation?
In vein inflammation (phlebitis), the wall of a surface vein is inflamed, mostly in the region of the leg (thigh, calf, knee, foot, ankle). If the acute inflammation is in an intact vein, doctors refer to it as thrombophlebitis. Varicophlebitis (vein inflammation in a varicose vein) is more common. Vein inflammation should be treated by a doctor and may last for a few days up to several weeks. If untreated, vein inflammation can lead to dangerous thrombosis (blood clot).
Causes and risk factors for vein inflammation
The blood in varicose veins flows more slowly than usual. This makes vein inflammation more likely to develop. This slower blood flow can be worsened by other factors, including long periods of bed rest or if the vein is compressed in one place by clothing that is too tight or over a long period of time.
There is a higher risk of thrombosis, particularly in pregnancy – this also increases the risk of phlebitis for pregnant women and women who have recently given birth.
Another common reason for vein inflammation is damage and injury to the venous wall. Such injuries may be caused by
- Infusions, during or after surgery for example,
- taking a blood sample,
- inserting a catheter (vein access) or
- an insect bite
for example. If bacteria gets in, bacterial vein inflammation can also develop. The composition of the blood also plays an important role in whether vein inflammation develops. The blood coagulation tendency may be higher owing as a result of other illnesses or drinking insufficient fluids. This can lead to the development of blood clots.
Recognising vein inflammation: Symptoms and signs
Vein inflammation is usually localised and can be very painful. Typical symptoms include:
- Sensation of pressure
- Sensation of warmth
- Hardening of the veins.
Preventing vein inflammation
You can take control of actively preventing vein inflammation and other venous conditions yourself by minimising the influenceable risk factors that have been described. Some tips:
- Basic therapy: Wear medical compression stockings on a daily basis if your legs are prone to varicose veins.
- Exercise: Avoid long periods of standing and sitting, and do vein exercises to activate your venous pump
- Sport: Activities such as swimming, hiking and Nordic walking activate your veins.
- Drink plenty of water: A lack of fluids makes the blood thicker, meaning that your risk of blood clots increases.
- Go to your doctor: Have your varicose veins treated.
- Risk factor: Take care of your health: Give up smoking because smoking alters the vascular walls.
Treatment of vein inflammation
The treatment for vein inflammation depends on its type and how serious it is. The doctor first establishes if the deep leg veins are affected or not.
Many patients with thrombophlebitis find that cooling the inflamed area eases the pain. Depending on the location and dimensions of the blood clot, there are different treatment methods. Treatment with anticoagulants to disperse the thrombus is possible. The clot can also be surgically removed. In some cases, just treating the symptoms is sufficient.
Basic therapy: Medical compression stockings for vein inflammation
The basic therapy involves wearing medical compression stockings that fit properly. They are particulary effective in combination with exercise: The compression stockings and activating the muscle pump ensure that the diameter of the veins is minimised. This means that the blood flows better in the direction of the heart. It no longer collects in the legs. Symptoms such as pain, swelling and feelings of tightness are significantly improved, leading to an increased quality of life.1
What happens when vein inflammation is left untreated?
Be on the safe side: Inflammation of the surface veins that is discovered and treated early on can often improve within a few days without any consequences for your health. If the vein inflammation remains untreated it can lead to pain lasting many weeks and also spread further. It is particularly problematic if the vein inflammation occurs near a branch of the deep vein system. If left untreated, this can lead to deep vein thrombosis deep vein thrombosis that, in turn, can lead to dangerous pulmonary embolism.
Which doctors treat vein inflammation?
If you have vein inflammation you should consult a medical specialist (phlebologist, angiologist, vascular surgeon, dermatologist) immediately.
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1 Rabe E et al. Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology 2018;33(3):163-184.
Your doctor makes the diagnosis and decides on the therapy. If necessary, your doctor can prescribe wound therapy products. The patient is advised by trained personnel (e.g. in a medical supply store, pharmacy, wound centre). After this, the patient receives products that are customised to meet their individual needs.
Everything You Need to Know about Phlebitis
Phlebitis may seem like an inconvenience, but if it’s left untreated, it can have serious consequences.
Twisted and swollen blood vessels aren’t just a symptom of varicose veins. In some patients, they can be caused by phlebitis, a serious venous inflammation resulting from an injury to the blood vessel wall. Because the affected vein is usually a superficial vessel located in the legs, the condition is often associated with varicose veins, but its complications can be just as severe.
Since it results in an inflammation of the blood vessel, phlebitis restricts circulation, increasing the risk of blood clots. While superficial phlebitis is unlikely to cause a significant blood clot, the initial swelling can quickly progress and lead to a pulmonary embolism, endangering deeper veins. If a clot travels to a deeper vein or forms within it, it can cause thrombophlebitis, a life-threatening condition that requires immediate treatment.
Despite its unpleasant consequences, phlebitis can be easily treated if diagnosed early, and it’s just as easily prevented. If you’ve suffered from phlebitis in the past or might be vulnerable to it, we’ll tell you what you need to know about your condition here and offer some advice on managing it.
What Causes Phlebitis?
Phlebitis is often caused by localized trauma to a vein. An IV injection, for example, can tear or puncture a vein, resulting in inflammation. Phlebitis can also result from extended inactivity, however, since immobility reduces the frequency of muscle contractions, and fewer muscle contractions can cause blood to pool in veins. In some cases, phlebitis can be a complication of surgery, especially if the procedure entailed some contact with the inflamed vein.
While phlebitis can affect anybody, some individuals are more likely to develop it than others. Because their conditions leave them more susceptible to blood clots, patients with connective tissue disorders or breast, pancreatic, and ovarian cancer are at greater risk of suffering from phlebitis. In addition, obesity, pregnancy, smoking, and a family history of blood clots all increase the likelihood of phlebitis.
What Are the Primary Symptoms?
Patients with superficial phlebitis may experience swelling, burning, itching, heat, tenderness, and redness along their inflamed veins. Phlebitis in the deeper veins can cause heavy pain and swelling throughout the limb containing the affected vessel, as well. In the most severe cases, patients may also suffer from a dangerously high fever, chest pain, and labored breathing.
How Is It Typically Diagnosed?
Most cases of phlebitis can be quickly diagnosed with a physical examination, but a noninvasive ultrasound might be needed to confirm the initial diagnosis, especially when treating larger veins in the upper leg. For narrower veins in the lower leg, a doctor or vein specialist might need to inject X-ray dye into the foot and track its upward progress through the veins in the leg.
Above all else, patients with phlebitis must ensure that the swelling hasn’t resulted in blood clots. A qualified professional can check for them with a D-dimer blood test, which measures any material released when a blood clot dissolves. If the results are negative, the patient should be free of clots.
While phlebitis can understandably cause some apprehension, treatments for it are simple and highly effective. As a preventative measure, your doctor or vein specialist might prescribe compression stockings, which stimulate blood flow in the legs and alleviate pain caused by superficial phlebitis. An active lifestyle will also promote circulation, lowering the likelihood of future occurrences.
While recovering from phlebitis, a combination of anti-inflammatory drugs and frequent elevation of the affected limb will reduce inflammation and encourage the flow of blood, preventing the condition from progressing and restoring normal function. If the inflammation is caused by an infection, your doctor will likely prescribe antibiotics, as well. In addition, patients with deep vein thrombophlebitis may need regular thrombolysis treatments to break down the blood clot, as well as a steady regimen of blood thinners for three to six months.
As daunting as phlebitis can be, it’s a highly treatable condition. If you’re concerned that you’re suffering from it, or worry that you might be susceptible to it, consult a vein specialist today to discuss your symptoms and treatment options.
Diagnostics and treatment of Phlebitis of the lower extremities in Kiev and Kharkov
Vessels ache, and the body temperature rises.
This is what the typical symptoms of venous phlebitis look like. How dangerous is the disease?
Phlebitis is an inflammation of the venous walls in a chronic or acute form. It is in its acute form that the disease causes the greatest discomfort, since the patient is constantly tormented by pain and high fever.
Chronic phlebitis is easier. Symptoms appear only with exacerbations, and the rest of the time, the inflamed vessels do not bother.
Phlebitis mainly develops in the vessels of the legs, although it sometimes affects other parts of the body.
His complications are dangerous.
Due to inflammation of the venous wall, blood clots often form. They disrupt blood circulation, increase the risk of thrombosis and other vascular diseases.
Causes of phlebitis
Inflammation of the walls of blood vessels is a protective reaction of the body to external stimuli.The problem doesn’t just happen.
Phlebitis of the lower extremities affects the walls of the veins for many reasons:
- Skin burns, abscesses
- Varicose veins
- Malignant tumors
- Streptococcal infections
- Mechanical damage to veins during injections
- Intravenous drug injection
- Removal of lymph nodes and disorders of lymph flow
- Stagnation of blood due to long immobility
- Introduction of the catheter into the vessels
- Complications after childbirth
However, inflammation is not always harmful.Phlebologists artificially cause inflammation of the venous walls to remove diseased veins – they inject sclerosant, which destroys the walls of the vessels and glues them together, stopping the movement of blood.
Depending on the cause and other factors, phlebitis is divided into types.
Types of phlebitis
Physicians use several classifications to classify diseases into groups.
At the site of inflammation inside the vein:
- Endophlebitis – the inner layer of the venous wall becomes inflamed
- Periphlebitis – the outer layer of the vessel is affected
- Panphlebitis – all vessel membranes are inflamed
Based on the location and causes of the disease, phlebologists have developed another classification.Phlebitis happens:
- Post-injection – inflammation appears when the vessels are irritated due to intravenous drug injections or blood sampling.
- Pain – affects the vessels of the legs, especially common in women after childbirth. Severe and intense pain.
- Migratory – chronic phlebitis, which periodically appears and disappears. Causes relapses. Veins and sometimes arteries become inflamed.
- Cerebral – due to infections, the vessels in the head become inflamed.
- Pylephlebitis – the largest vein in the abdominal cavity is inflamed. Always with complications.
- Allergic – chronic phlebitis. It develops due to contact with allergens.
- Thrombophlebitis is a dangerous form of phlebitis, since blood clots form near the site of inflammation. Occasionally enter the bloodstream. Particles of blood clots enter the pulmonary arteries and are seriously harmful to health. Sometimes they even kill.
Division by type of inflamed veins:
- Phlebitis of deep veins
- Phlebitis of superficial veins
Symptoms of phlebitis species are similar, but some species have their own characteristic features.
The main signs of inflammation of the superficial veins:
- Sick veins are tense and it hurts to touch them
- The skin next to the vessel turns red and thickened
- Red stripes are visible along the inflamed vein
The symptoms of deep vein phlebitis are slightly different:
- Edema forms next to diseased vessels
- Body temperature rises
- The skin around the inflamed area brightens and becomes milky white
Phlebitis in the head.Inflammatory processes in the brain are distinguished by unique features that are not similar to symptoms of other types of disease.
Cerebral phlebitis calls:
- High blood pressure
Let us remind you that signs of the disease do not always appear. Chronic phlebitis is insidious. Its symptoms appear and disappear – it is difficult to catch the disease. To do this, you need to know whether you are at risk for phlebitis or not.
Who often suffers from phlebitis
The risk of disease is increased due to several factors:
- Varicose veins
- Intravenous drug injection
- Delivery of drugs to veins through a catheter
If you are in one of the risk groups for phlebitis, then carefully monitor any manifestations of the disease.
Get regular check-ups with a phlebologist.
Diagnosis of phlebitis
To check for phlebitis on the leg, doctors usually order a duplex ultrasound scan. It consists of two parts:
During an ultrasound, the phlebologist assesses the condition of the vessels – their image is shown on the screen and the doctor notes any damage.
Doppler does not show veins. This procedure measures the speed of blood movement in certain areas of the vessels.
The combination of ultrasound and Doppler ultrasonography gives the doctor enough information for an accurate diagnosis. Helps to choose the method of treatment.
Types of phlebitis treatment
A phlebologist treats phlebitis using an integrated approach – a combination of drugs, therapy and compression hosiery. At home. Or in the hospital, but only in the most severe cases.
Drug treatment for phlebitis includes:
- Nonsteroidal anti-inflammatory drugs
- Antibiotics – when there is a risk of sepsis and purulent lesions
- Blood thinning drugs
- Preparations for relieving edema and pain, strengthening the venous wall
- Means for improving blood circulation.
If the disease is caused by an infection, the doctors will first eliminate it. Then the inflammation is treated.
Surgical operations with the removal of blood vessels are performed extremely rarely – with inflammation of deep veins and a high risk of complications. For most patients, this method of treating phlebitis is not applied.
Prevention of phlebitis
The disease in severe forms causes blood clots and requires removal of blood vessels.
Yes, this rarely happens.
But the probability remains and therefore it is much easier not to treat phlebitis, but to engage in its prevention.Nothing complicated.
Here’s what will help prevent disease:
- Smoking cessation
- Charge every day
- Proper nutrition
- Daily walks in the fresh air
- Treatment of varicose veins at an early stage
- Timely care of wounds and abscesses
- Compression hosiery
- Refusal of hormonal drugs
Of course, no one will give you a guarantee of safety against phlebitis.But preventive measures will help reduce the risk of inflammation of the venous walls, which is not bad at all, given the dangerous complications of the disease.
Did the trouble pass you by? See a phlebologist at our medical center.
Doctors of the Vein Institute will detect phlebitis and prescribe treatment in 30 minutes
Our phlebologists diagnose vascular diseases using Toshiba APLIO ultrasound systems. Veins are shown in high resolution on the monitor screen. All damage is visible.So doctors quickly detect diseases and determine their stage.
Modern equipment is just one of the advantages of the Venin Institute clinic.
We also have experienced doctors.
They have cured thousands of patients from vein problems over the past 20 years. More than 4000 – successful operations. The rest – conservative treatment of drugs, exercise and compression hosiery.
Join them. Forget about vascular disease and return to a fulfilling healthy life.
Our phlebologists are known not only as physicians, but also as researchers and inventors. They write scientific articles. Oksana Ryabinskaya and Rustem Osmanov published 70 scientific papers each and patented 9 inventions each.
Doctors of the Venin Institute actively participate in international conferences. Oksana Ryabinskaya is well known among the world community of phlebologists – in 2018-19 she spoke to foreign colleagues three times at phlebological forums in Melbourne, Yaremche and Krakow.
Come to our medical center and get rid of phlebitis and other vein diseases without pain and scars.
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90,000 Phlebitis: causes, symptoms and treatment in Moscow
Phlebitis is an inflammatory disease that affects the walls of the venous vessels.The disease can be acute or chronic. Phlebitis often develops against the background of progressive varicose veins. As a rule, the lower extremities are exposed to inflammation, but the development of phlebitis of the hands is possible. If the treatment of phlebitis of the veins is inadequate or untimely, blood clots form after changes in the inflamed venous wall. At this stage, phlebitis flows into thrombophlebitis, which is more difficult to treat and can cause serious complications. Treatment of phlebitis is conservative, involving the use of medications, physiotherapy procedures.Experienced phlebologists with many years of experience are engaged in the treatment of such a vascular disease at the International Clinic “Hemostasis”. Our specialists successfully treat even advanced forms of pathology, so if you need qualified medical care, please contact us.
General information about the disease
Phlebitis is an inflammation of the venous walls, which in most cases is a consequence of advanced varicose veins. The disease mainly affects the superficial veins, but in the absence of adequate therapy, it spreads to the deep vessels, causing deep vein phlebitis.As the disease progresses, nearby tissues may be involved in the pathological process. According to the latest statistics, the disease is diagnosed mainly in elderly patients after 50 years. Moreover, women suffer from phlebitis more often than men.
The inflammatory process can be caused by various etiological factors, such as:
- mechanical damage, etc.
The disease can also develop after a chemical burn of the vessel. In certain situations, phlebitis can be artificially induced. For example, during the treatment of varicose veins in phlebology, a technique called sclerotherapy is often used. The principle of operation of the procedure is based on the introduction of a special drug that causes aseptic phlebitis, which contributes to the subsequent adhesion of the venous walls.
Depending on the location of the inflammation in the venous wall, the following types of phlebitis are distinguished:
- Periphlebitis.It is characterized by inflammation of the external venous membrane. It often develops when the inflammatory process of their surrounding tissues spreads to the walls of the veins.
- Endophlebitis. With this pathology, the inflammatory process is localized on the inner lining of the vessel. It occurs due to damage to the inner lining of the vein or injury to the vessel. The main causes of endophlebitis: catheterization, prolonged stay of the needle in the vessel with drip administration of drugs.
- Panphlebitis. It is characterized by the defeat of all vessel membranes.
Taking into account the etiological factor, the following forms of phlebitis are distinguished:
- Allergic. It develops as a result of an allergic reaction of the body to the introduction of a foreign agent. This type of phlebitis often becomes chronic.
- Painful. Develops in women after childbirth. It affects the lower extremities, is characterized by an acute course, accompanied by a pronounced pain symptom.
- Migrant. This disease affects mainly young men.The superficial veins of the lower or upper extremities are involved in the pathological process. Migratory phlebitis is often accompanied by damage to the arteries, characterized by a long, chronic course.
- Cerebral. Inflammatory processes are localized in the vessels of the brain. Phlebitis of cerebral vessels is mainly the result of a previous infection.
- Pylephlebitis. It is characterized by inflammation of the collar vein, often a complication of the inflammatory process in the abdominal cavity.
- Infectious. May affect any part of the human body.
By the nature of the course, they are distinguished:
- Acute phlebitis. It is characterized by pronounced symptoms and an acute course. Requires emergency medical attention.
- Chronic phlebitis. It is characterized by a sluggish current symptomatology, with a confluence of unfavorable factors, it is prone to relapse.
Causes of phlebitis
Phlebitis of superficial veins begins to develop as a result of the onset of an inflammatory process that affects the walls of the vessel.Factors contributing to its occurrence:
- susceptibility to allergic reactions;
- immune dysfunction;
- chronic venous insufficiency;
- blood clotting disorder;
- violation of lymphatic flow;
- varicose veins;
- physical inactivity, contributing to the development of stagnant processes;
- obesity, which increases the load on the lower limbs;
- work in which a person is forced to constantly stay on his feet.
90,029 vascular injuries;
Post-injection phlebitis of the upper extremities also often occurs against the background of varicose veins. Pathology may be the result of trauma to the vessel during injection or drip intravenous administration of the drug, as well as prolonged presence in the vein of the catheter. Post-injection phlebitis is mainly encountered by women who use injecting drugs, as well as those undergoing chemotherapy.
With inflammatory lesions of superficial veins, local symptoms come to the fore, such as:
- severe pain, tension in the area of the affected vein;
- redness and thickening of the skin over the inflamed area;
- the formation of red stripes along the affected vessel;
90,029 increase in body temperature.
The symptoms of deep vein phlebitis will vary. First of all, the patient’s body temperature rises, soreness, severe swelling occurs in the affected area. The skin over the affected area turns pale, taking on a marbled white tint
If there is no treatment for acute phlebitis, the risk of thrombophlebitis increases, in which blood clots form on the inflamed vessel walls. With chronic course
Analyzes and Diagnostics
The superficial form of phlebitis is determined already during the initial examination.The affected limb looks edematous, hyperemic, on palpation, a compaction is felt over the inflamed area. To diagnose superficial and deep phlebitis, a comprehensive diagnosis is prescribed, consisting of the following types of procedures:
- Hemostasiogram. This is a laboratory blood test to determine hypercoagulability and a tendency to thrombus formation.
- Ddimer – marker – thrombus formation
- Platelet aggregation. Blood test indicating risk of thrombosis, need for treatment
- Blood test for the presence of an infectious agent.
- Ultrasonic duplex scanning of vessels. It allows you to assess the structure and patency of veins, as well as to assess the nature of blood flow through them, to determine the exact localization of the pathological process in the veins, to assess the nature of blood flow through the affected vessel.
- USGD veins. Doppler study allows you to assess the degree of their patency, to identify areas with impaired blood circulation.
Additionally, computed or magnetic resonance imaging can be prescribed, which will allow you to examine in detail the veins, their location, and see the zones of inflammation.
Treatment of phlebitis of the arm or leg can be carried out on an outpatient basis or in a hospital setting. It all depends on the nature of the course of the disease, the type, the presence of concomitant complications. If superficial venous phlebitis is diagnosed, treatment is carried out on an outpatient basis. To relieve the inflammatory process and concomitant symptoms, as well as to strengthen the venous walls and normalize blood flow, the following groups of drugs are used:
- Nonsteroidal anti-inflammatory drugs.They help to eliminate the inflammatory process, swelling, hyperemia, have a pronounced analgesic effect.
- Venotonic. They strengthen the vascular walls, increasing their elasticity, and contribute to the normalization of blood circulation.
- Anticoagulants. They have a blood thinning effect, prevent thrombus formation.
If necessary, broad-spectrum antibiotics are used, as well as antihistamines. After stopping the inflammatory process, phlebitis of the lower extremities can be treated using physiotherapeutic procedures that:
- restore tissue trophism;
- stimulate regeneration processes;
- increase local immunity;
- prevent relapse;
- have a tonic effect.
The following methods of physiotherapy are effective for phlebitis:
- drug electrophoresis;
- magnetic or laser therapy;
- diadynamic currents;
- mud applications;
- acupuncture, etc.
To prevent relapses, it is recommended to regularly use compression hosiery, which will protect the veins from overstretching, help normalize blood circulation and intravascular pressure, and minimize the risks of the spread of pathology.
The following prevention rules will help prevent the development of phlebitis:
- observance of the foundations of a healthy lifestyle;
- cessation of smoking, alcohol consumption;
- proper nutrition;
- body weight control;
- connection of moderate physical activity with a sedentary lifestyle;
- normalization of the work schedule and rest
- hemostasiogram, DDimer, AT3 – blood test once a year.
If any suspicious symptoms appear, do not self-medicate, but seek professional help from a phlebologist as soon as possible. Only correct and adequate treatment will help stop the progression of inflammation and prevent serious complications.
Prevention of phlebitis during pregnancy
During pregnancy, every woman may face phlebitis, especially if she was previously diagnosed with varicose veins of the lower extremities. During pregnancy, most drugs used to treat phlebitis are categorically contraindicated.Therefore, it is necessary to take all measures to prevent such vascular disease.
Throughout the entire period of bearing a baby, it is useful to follow these simple recommendations:
- take daily walks in the fresh air;
- regularly do exercises with a general strengthening effect;
- control weight;
- eat right;
- in the presence of suspicious symptoms, consult a doctor, and do not wait for the situation to resolve on its own.
With phlebitis, you need to radically reconsider your eating habits and give up foods containing a large amount of salt, animal fats, preservatives and other chemical additives. It is desirable to eat often, but little by little. Prepare dishes with gentle methods: steamed, in the oven, grilled or simply boiled in water.
Diet for thrombophlebitis
With thrombophlebitis, the diet should consist of the following food groups:
- fish, seafood;
- cereals: buckwheat, rice, oatmeal;
- fresh vegetables, fruits, berries, herbs;
- dairy and fermented milk products;
- freshly squeezed juices, fruit drinks;
- dry goods, seeds, nuts.
90,029 lean meat;
Consequences and complications
Against the background of untreated acute phlebitis, thrombophlebitis develops. Deep vein thrombophlebitis can cause pulmonary embolism, which is very often fatal.
In the longer term, the risk of developing chronic venous insufficiency increases, against the background of which complications such as trophic changes, abscesses, and phlegmon often develop. Pylephlebitis can cause renal and hepatic failure.
Cost of phlebitis treatment
The cost of phlebitis treatment for each patient is calculated separately. The following factors are taken into account:
- the stage at which the disease is diagnosed;
- the methods of therapy used;
- duration of the course of treatment;
- complications, etc.
To get a more extensive consultation and make an appointment with a specialist of the International Clinic “Hemostasis”, call +7 (495) 125-06-13 or fill out the online form on the website.Ultrasound of vessels is done by an expert, professor Balakhonova T.V., treatment is carried out by a phlebologist, professor Shimanko A.I.
Inflammation of veins
What is inflammation of the veins?
When a vein is inflamed (phlebitis), the vein wall becomes inflamed. Veins in the leg area (thighs, legs, feet, ankles) are usually affected. If acute inflammation develops in a previously healthy vein, it is commonly referred to as thrombophlebitis.Varicophlebitis (inflammation of the veins with varicose veins) is more common. Inflammation of the veins should be treated by a doctor. The treatment lasts from several days to several weeks. If left untreated, inflammation of the veins can lead to thrombosis.
Causes of phlebitis
Slowing blood flow is the most common cause of phlebitis, especially with a weakened venous wall prone to varicose veins.Phlebitis can also develop if a vein is squeezed for a long time by tight clothing or, for example, is squeezed by the edge of a chair. Another common cause is venous catheters, which are placed in a vein for several days to administer infusions or medications. Phlebitis can also be caused by mechanical damage to the venous wall or the penetration of bacteria after surgery and with prolonged bed rest.
Another common cause of venous inflammation is damage to the vessel wall.Such damage can be caused by:
- Infusion, for example, during or after surgery,
- blood sampling,
- venous access (catheter) or
- insect bite
Ingestion of bacteria can cause inflammation of infectious phlebitis. Blood composition also plays an important role in the development of phlebitis. Blood clotting can increase due to diseases or a lack of fluid in the body. This can lead to the development of blood clots.
Recognizing phlebitis: symptoms and signs
Vein inflammation is usually local and very painful.Typical symptoms include:
- Feeling of pressure
- Feeling of heat
- Thickening of a vein.
Prevention of phlebitis
You can independently prevent the development of phlebitis and other venous diseases, minimizing the risk factors described below. Tips:
- Basic Treatment: Use medical compression hosiery daily if you have a predisposition to varicose veins.
- Exercise: Avoid prolonged standing and sitting, and do vein support exercises to activate the muscle-venous pump.
- Sports: Sports such as swimming, hiking and brisk walking support your veins.
- Drink plenty of water: Lack of fluid thickens the blood and increases the risk of blood clots.
- See a doctor: Varicose veins need to be treated.
- Risk Factor: Take care of your health: quit smoking, because smoking changes the walls of blood vessels.
Treatment of venous inflammation depends on its type and severity. The doctor first checks to see if the deep veins are affected.
Many patients with thrombophlebitis find that cooling the inflamed area relieves pain. There are different treatments depending on the location and size of the blood clot. Treatment with anticoagulants to dissolve the thrombus is possible.The clot can also be surgically removed. In some cases, symptomatic treatment is sufficient.
Main treatment: Use of medical compression hosiery for phlebitis
The main treatment involves the use of properly selected medical compression hosiery. It is especially effective when combined with exercise: compression hosiery stockings and activation of the muscle-venous pump ensure that the diameter of the veins is reduced. This means that blood moves faster towards the heart and does not accumulate in the vessels of the legs.Symptoms such as pain, swelling and pressure are significantly reduced, resulting in an improved quality of life.
What happens if phlebitis is left untreated?
Easily diagnosed superficial phlebitis is well treated and often regresses within a few days without any complications. If phlebitis is not treated, then it can progress and cause long-term pain syndrome lasting up to several weeks. The situation becomes especially dangerous if the vein affected by phlebioma is connected to the deep venous system.If, in this case, treatment is not promptly started, deep vein thrombosis may develop with a high risk of pulmonary embolism.
Which doctor treats phlebitis?
If you develop phlebitis, you should immediately see a doctor (phlebologist, vascular surgeon, dermatologist).
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How do veins work?
90,000 Phlebitis and thrombophlebitis | Vascular surgery
Phlebitis and thrombophlebitis treatment in Lipetsk
• Phlebitis is an inflammation of the walls of the veins and can be caused by various types of damage to the vascular wall, it causes a disturbance in the normal blood flow and forms a predisposition to the formation of blood clots
• Pain, swelling, redness and induration along the vein – the main symptoms of phlebitis
• Thrombophlebitis is the formation of thrombotic masses inside the lumen of a vein due to phlebitis
• Distinguish between superficial and deep vein thrombophlebitis
• Superficial phlebitis more often has a favorable prognosis and is better treated at home
• Deep vein thrombosis is a serious complication and requires urgent special therapy
• Simple measures prevent phlebitis
Superficial phlebitis affects veins that run directly under the skin.With deep vein thrombophlebitis, blood clots form in the veins deep in the soft tissues. The presence of superficial phlebitis does not necessarily mean the development of deep vein thrombosis, superficial phlebitis on the hands and feet responds well to treatment and has a favorable prognosis. An exception to the rule is thrombosis of the great saphenous vein of the leg, which is a serious and dangerous disease and can be combined with deep vein thrombophlebitis of the leg.
Deep vein thrombophlebitis is a serious problem and can lead to life-threatening complications – the flotation of a blood clot into the pulmonary artery with the development of thromboembolism.Pulmonary embolism often ends in rapid death of a person or makes him disabled.
Common causes and predisposing factors for the development of phlebitis are:
• Local trauma to the vein
• Prolonged involuntary immobilization – for example, being behind the wheel or long flights
• Installation of intravenous catheters during treatment
• Postoperative period, especially after traumatological and orthopedic manipulations
• Long period of immobilization
• Varicose veins
• Concomitant oncological diseases and blood clotting disorders
• Disruption of normal venous outflow after removal of lymph nodes in breast cancer
• Taking hormonal drugs, including contraceptives
• Smoking and obesity
Pain, swelling, redness of the skin, induration along the vein are the main symptoms of superficial phlebitis.Rarely, an increase in body temperature to subfebrile occurs with phlebitis of deep veins. Fever indicates the addition of a bacterial infection with the development of a septic form of thrombophlebitis. Palpation (when palpating with fingers) detection of a painful cord under the skin indicates a high probability of thrombosis of the inflamed vein. With phlebitis of deep veins, in addition to swelling, pain and redness of the skin, pain when walking often appears.
The diagnosis of superficial thrombophlebitis is made in the presence of the above patient complaints.An ultrasound examination of the veins allows you to reliably confirm or deny the diagnosis. The diagnosis of deep vein thrombosis is more difficult and always requires an in-depth ultrasound examination. Ultrasound examination of veins in the ANDROMEDA Clinic is carried out on a modern apparatus of the expert level “PHLLIPS”. The ultrasound examination method is accurate, cheap and reliable. CT studies, MR angiography and contrast-enhanced venography are used much less frequently.
The laboratory test for D-dimers, which is also performed at the ANDROMEDA Clinic, makes it possible to assess the coagulation capacity of the blood and the tendency to thrombus formation.Performed after the appointment of a vascular surgeon at the ANDROMEDA Clinic.
It is necessary to differentiate phlebitis with the symptoms of cellulite, skin manifestations of allergies, dermatitis, inflammation of the lymph nodes and blood vessels, insect bites, etc. Only a vascular surgeon can reliably diagnose and prescribe the correct treatment. Sometimes you may even need a skin biopsy and a consultation with a dermatologist, who also accepts at the ANDROMEDA Clinic.
Treatment of phlebitis depends on the affected area, the prevalence of the process, symptoms and concomitant pathology.
In general, for the treatment of superficial phlebitis, the use of local treatment and non-steroidal anti-inflammatory drugs is sufficient. Medical compression stockings are also used in the treatment of superficial phlebitis as prescribed by the vascular surgeon of the ANDROMEDA Clinic. Antibiotics are prescribed for strict indications when a bacterial infection is attached. If an intravenous catheter is the cause of the phlebitis, it must be removed.
With deep venous thrombosis, confirmed by an ultrasound examination, anticoagulants (drugs that thin the blood) are prescribed by the attending physician.The choice of anticoagulant and its dosage is carried out exclusively by the vascular surgeon.
In exceptional cases, with the development of widespread venous thrombosis of the lower extremities, it may be necessary to install a cava filter in the inferior vena cava to prevent pulmonary embolism. The kava filter is installed in a specialized angiosurgical operating room.
The healing process with phlebitis can last for several weeks, and the use of anticoagulants continues from a week to a month after clinical recovery.
Prevention of phlebitis and thrombophlebitis
Preventive measures are simple and easy to do:
• Early activation of patients in the postoperative period
• Exercises for legs on long flights and road trips
• Good care of intravenous catheters
• Quitting smoking, reducing body weight to normal
Compression stockings are often recommended for wearing, especially for patients after deep vein thrombosis.Patients with low mobility, especially those who are about to undergo orthopedic surgery, are prescribed anticoagulants in a hospital setting and after discharge from the hospital.
90,000 Thrombophlebitis of the superficial vessels of the lower extremities – causes, symptoms and treatment – Medcompass
Thrombophlebitis of the superficial vessels of the lower extremities
Phlebitis is an acute or chronic inflammation of the venous wall. Depending on the depth of the lesion of the veins, superficial and deep phlebitis are distinguished.
Thrombophlebitis is accompanied by the formation of a blood clot in the affected vein. Diseases mainly affect the veins of the lower extremities, however, they can also be observed in vessels of other localization.
Thrombophlebitis is a more serious disease, since a thrombus can completely block the lumen of the vessel, break off and block the pulmonary artery with the blood flow.
Symptoms of the disease
In acute phlebitis of superficial veins, the latter become tense and painful.The skin above them turns red and thickens. Sometimes reddish streaks appear along the affected veins. There may be local and general hyperthermia (temperature rise), which lasts no more than 5 days.
In the chronic course of the disease, the picture is smoother.
With the addition of thrombosis, severe muscle pain in the limbs, their swelling can be observed. The pain increases with palpation, movement, prolonged walking and standing.
With phlebitis of the portal vein (pylephlebitis), a pronounced picture of purulent intoxication is observed.The patient’s condition sharply worsens, he develops weakness, headache, vomiting, severe pain in the right hypochondrium, jaundice increases. The body temperature rises significantly. Pylephlebitis is a life-threatening disease.
Causes of the disease
The most common cause of superficial phlebitis is intravenous drug administration, catheterization and other vascular injuries.
In addition, phlebitis can be a complication of varicose veins.Abscesses and various infected wounds can provoke the development of the disease.
A risk factor for the development of thrombophlebitis is prolonged immobilization, which is accompanied by blood stasis and clot formation.
Inflammatory diseases, excess weight, smoking, hormonal disorders, pregnancy, childbirth and other gynecological operations are also provoking factors.
Diagnosis of phlebitis and thrombophlebitis is not particularly difficult, as it has a fairly clear clinical picture.A phlebologist or vascular surgeon will recognize the complaints, the timing of the first symptoms and possible risk factors. With the help of an examination, the doctor determines areas of hyperemia without clear boundaries along the course of the vein, the skin over which has an elevated temperature. On palpation, a dense, oblong, painful cord can be determined. You can also feel local swelling of the subcutaneous tissue. Skin color depends on the duration of the disease, and can range from reddish to bluish and brown.
The diagnosis is confirmed by instrumental and laboratory research methods.
Laboratory tests of significance are:
- General blood test
- Biochemical blood test
Ultrasound scanning of blood vessels with color mapping of blood flow is the most informative. The study shows the direction and speed of blood flow, which is coded in different colors. In addition, the method allows you to study in detail the anatomical changes in the bloodstream, to determine the state of deep and superficial veins, their walls, valves, the presence and size of thrombotic masses.The study also shows the risk of pulmonary embolism, which directly determines the tactics of treatment.
X-ray contrast phlebography is of great diagnostic value for determining the apex of a thrombus when thrombosis spreads to the inferior vena cava and iliac veins.
Complications of superficial thrombophlebitis develop quite rarely, but their severity does not allow ignoring this fact. The most common of them:
- Hyperpigmentation of the skin over the affected vessel
- Spread of infection in the subcutaneous tissue – cellulitis
- Deep vein thrombosis
- Pulmonary embolism
- Streptococcal lymphangitis.
Treatment of the disease
Treatment of phlebitis is carried out conservatively and surgically.
The most effective drug and local treatment in the acute period of the disease. Elastic bandaging of the limbs, bandage, compression stockings or knee-highs is used. Local cooling provides a good analgesic effect. From pharmaceuticals, non-steroidal anti-inflammatory drugs, antiplatelet agents, phlebotonics and anticoagulants are used.
Surgical treatment should be considered in the transition of thrombosis to deep veins, with ascending thrombophlebitis of the trunks of the saphenous veins.
Inflammation of the veins in the legs – Just about technology
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How to relieve inflammation of the veins with varicose veins on the leg?
People suffering from varicose veins often face such a problem as phlebitis (inflammation of the vascular walls). The disease provokes symptoms of inflammation of the veins in the leg, which occur in acute and chronic form.
The main causes of the inflammatory process are disorders of homeostasis due to systemic pathologies and the introduction of infection into the vein cavity.What are the symptoms of phlebitis, and how to treat it, is explained in the article below.
Reasons for the development of phlebitis
Over time, varicose veins lead to deformation of blood vessels, which in turn causes impaired blood flow, increases the risk of thrombus formation and occlusion (blockage of the lumen of the vessel). Constant increased pressure and changes in the structure of the vein leads to inflammation of its walls.
It should be recalled that phlebitis is the result of pathogens entering the bloodstream, exposure to certain medications and vascular injury.In rare cases, the cause of phlebitis is inflammation of the tissues adjacent to the veins.
In addition, the following factors increase the likelihood of developing pathology:
- Obesity and overweight. Extra pounds is an additional load not only on the vascular system, but also on the entire body.
- Propensity to allergic reactions. There is a list of aggressive medications, such as antibiotics, that increase the chance of inflammation in the walls of blood vessels.
- Pregnancy. Phlebitis can develop both during gestation and immediately after birth.
- Inactive lifestyle. Physical inactivity, along with obesity, negatively affects the state of blood vessels and can provoke this disease.
Excessive loads can be attributed to this group of factors. With varicose veins, it is important to alternate work with rest, and also not to put a lot of stress on the legs.
Mechanism of the inflammatory process
The inflammatory process affects the vascular endothelium, disrupts microcirculation and atrophies tissues.The human body begins to respond to stimuli, resulting in the formation of exudate. It is a protein-rich liquid that is secreted into the tissue structure and body cavity from small vessels.
If the permeability of the vascular wall is too high, then the exudate is released into nearby tissues. At the same time, tissue proliferation is observed – the process of cell division aimed at compensating for damage.
For proliferation, the work of inflammatory mediators – biologically active chemicals – is necessary.They improve the permeability of the vascular walls, ensuring the release of exudate. The fluid contains eosinophils that fight inflammatory pathogens.
Fresh information: How to use a leg bandage for varicose veins?
In addition, mediators increase the activity of fibroblasts and platelets. Their action is aimed at the formation of a clot capable of blocking the damaged vessel wall.
Signs of phlebitis
There are different signs of phlebitis classification: localization, course of etiology, degree of damage to the venous wall.
Depending on the localization, the following forms of phlebitis are distinguished: superficial, phlebitis of deep veins, migrating.
The migratory form of phlebitis is one of the manifestations of systemic vasculitis. This disease develops as a result of failures in the immune system.
It affects the veins of the lower and upper extremities, resulting in inflammation in different vessels. Systemic vasculitis has nothing to do with varicose veins.
This pathology develops against the background of autoimmune, oncological diseases or is accompanied by allergic reactions.
A distinction should be made between the acute and chronic course of the disease. The acute form of phlebitis is characterized by a pronounced clinical picture. In the chronic course of the disease, mild symptoms are observed.
Depending on the degree of vascular lesion, the following forms of phlebitis are distinguished:
Clinical picture of venous inflammation
The symptomatology of the disease largely depends on which veins are affected by the inflammatory process. If it is observed in the superficial veins, then the symptoms are very similar to varicose veins. Therefore, many patients do not pay special attention to the initial symptoms of pathology and often go to the doctor too late, when inflammation leads to more serious consequences.
The initial signs of superficial phlebitis include a feeling of heaviness in the legs mainly in the evening, slight swelling of the lower extremities, the presence of a convulsive syndrome in the lower leg, similar to potassium deficiency, a feeling of heat in the calves when the legs are located on a hill.
If the patient does not seek medical help on time, the pathology becomes acute. In this case, the following symptoms occur:
- inflamed red vein is visible;
- on palpation, its compaction and expansion are felt;
- the area of the limb where there is an inflamed vein, hot and red;
- signs of general intoxication of the body – migraine, hyperthermia and lethargy.
Phlebitis and thrombophlebitis of the lower extremities of deep veins does not have such vivid clinical signs.For a long time, the disease proceeds in a latent form. But with significant lesion of the veins, acute symptoms appear:
The chronic form of pathology is very often perceived as ordinary fatigue.People complain of recurrent leg pain, low-grade fever (37-37.5 degrees) and edema. A slight discoloration of the skin is also possible.
Symptoms in acute course
In acute inflammatory process, hyperthermia (up to 39 degrees) occurs, a strong sensation of pain in the leg and swelling. The skin tightens, shines, and its shade becomes purple or cyanotic.
On palpation, the affected vein is very painful, often colder than healthy vessels.The pulse is not felt at all or is very weak. There is also an increase in lymph nodes.
In the course of the inflamed vein, trophic ulcers and abscess develop – external manifestations of suppuration. The acute process can last from 3 weeks to 2 months. It is almost impossible to recover in such cases: the pathology takes on a chronic or subacute form.
As a rule, acute phlebitis affecting the superficial vein is not accompanied by severe pain. The temperature rises slightly, and the swelling is small.On palpation, a thickening of the affected vein is felt, occasionally infiltrates. The disease in acute form lasts from 10 days to 1 month.
If thrombosis is present against the background of phlebitis, then a purulent process is quite possible. In such a situation, the patient complains of hyperthermia (up to 39 degrees). The tissue is very soft to the touch, hyperpigmentation may appear.
Diagnostics and treatment of pathology
To identify the inflammatory process in the body, the doctor sends you to the delivery of laboratory tests.If it is confirmed, then an increased level of eosinophils, platelets and leukocytes is detected in the blood.
In addition, instrumental diagnostic methods such as ultrasound of the lower extremities and duplex scanning are shown. They help to assess the condition of the walls of blood vessels, nearby tissues and blood circulation.
Fresh information: Is it possible to run with varicose veins in the legs?
When confirming the diagnosis, the doctor develops an effective therapy regimen, which includes the following components:
- taking medications;
- wearing compression stockings.
In case of inflammation of the veins of the lower extremities, drug treatment consists in the use of the following drugs:
Local analgesics are used to relieve pain. In the chronic course of the pathology, outpatient treatment is underway, in the acute form, hospitalization is necessary.
When the exacerbation of the pathology is behind, physiotherapeutic procedures are carried out: barometric effect, microwave, laser therapy, amplipulse, dorsonvalization and others.
The question remains among many patients: “If a vein in the leg is inflamed, how to treat it at home?” It is better not to self-medicate and not to use traditional medicine methods, but immediately consult a phlebologist.
Prevention of venous inflammation
In order to prevent the development of the disease or to suspend the defeat of the veins during its treatment, it is necessary to follow certain recommendations.
Moderate physical activity should be alternated with rest.
You cannot sit cross-legged, it is also contraindicated to be in one position for a long time (standing or sitting).
It is worth protecting yourself from heavy lifting. If the patient’s work is associated with hard physical labor, he will have to change his occupation.
It is necessary to follow the rules of a healthy diet, especially to protect the intake of large amounts of fats and fast-digesting carbohydrates.
Be sure to stop drinking and smoking.
Only comfortable shoes should be worn that do not bind the foot. It is better to refuse heels.
Taking medications is carried out only after consulting the attending physician.
During the period of therapy, it is necessary to follow all the instructions of a specialist.
If you follow the rules of prevention, the patient will forget about the severe symptoms of venous inflammation and will prevent the occurrence of thrombosis, trophic ulcers and necrosis of the tissue structure.
About the methods of arresting inflammatory processes in the veins is described in the video in this article.
What to do if a vein in your leg is inflamed?
Inflammation of the veins in the legs in medical practice is called phlebitis. This ailment is currently faced by both the elderly and those after the age of 30.
This disease indicates a violation of the blood flow through the vessels and veins of the lower extremities. The inflammatory process develops due to changes in the structure of the venous walls, the formation of small blood clots, which clog the vessels and disrupt its full movement.
Signs of illness
Phlebitis makes itself felt by swelling of the legs, which is accompanied by pain. When veins are blocked, their walls expand and bulge outward. Thus, this disease is not only a physical pain, but also an aesthetic problem.
An inflamed vein in the leg is recognized by the appearance of redness on the skin, accompanied by a high body temperature and chills.
Varicose veins are considered the initial stage of deep vein inflammation. Symptoms such as a translucent mesh of blood vessels through the skin, frequent pain in the lower extremities give rise to referral to a competent doctor.
Inflamed veins in the leg require an individual approach from specialists.
Self-treatment can only weaken the symptoms, partially eliminate the external signs of the disease, but not affect the cause of their periodic manifestation.
Factors contributing to inflammation of the veins in the legs
Doctors identify a number of main reasons why inflammation of the veins of the lower extremities develops. These include:
- regular hard physical work;
- carrying a child;
- sedentary lifestyle;
- surgical procedures on the legs;
- untreated varicose veins;
- infection of the body with pathogenic bacteria through external skin lesions;
- thick blood;
- Constant nervous tension;
- improper nutrition;
- Incorrect application of bandages during first aid for bruises, dislocations, cuts;
- overexcitement and stress;
- tight and uncomfortable shoes;
- shoes with heels;
- “jumping” blood pressure.
90,029 injuries sustained;
Types of disease
Doctors diagnose superficial phlebitis and deep phlebitis. Inflammation of superficial veins is easier to detect than deep vein dysfunction. Inflammation of deep veins is not determined by external signs, but is manifested by pain, cramps, tingling in the legs.
Revealing of inflammatory processes of deep veins occurs through the use of diagnostic medical equipment. Ultrasound and duplex scanning allows you to reliably assess the condition of the walls and take measures to restore them and improve their functioning.
Thrombophlebitis (blockage of veins) is a progressive form of inflammation of the veins in the legs and is more difficult to treat than the initial stage of the development of the disease. A negligent attitude towards such a diagnosis can lead to the formation of trophic ulcers, increased perceived pain, inactivity, and even disability.
Pain in the veins should not only be alarming, but also push for an immediate visit to the doctor. If the veins are not able to provide full permeability to the blood flow, the load on the arteries and the vascular system increases, which is fraught with the development of heart diseases along with phlebitis.
If the inflammation of the veins in the legs is not treated, you should not expect any improvement in well-being. Pain in the legs at the beginning of the disease periodically worries, and over time becomes chronic.
When giving yourself first aid, the first step is to relieve the inflammation that causes pain in the legs. Everyone should know what to do in order for the veins to stop inflamed even more.
First of all, you need to limit sunbathing, physical activity and cool your feet with the help of herbal cool baths, compresses from cabbage or grape leaves, plantain.
Cooling sore spots will allow you to draw out the heat, and the lying position (legs above the level of the body) will relieve the load on the heart and achieve outflow of blood from the limbs, which will effectively affect the reduction of swelling of the legs.
First aid is not a medical procedure, but only relieves the manifestations of inflammation of the veins in the legs. As for how to treat veins correctly and with what, this is a separate question. It is possible to eliminate inflammation both by conservative methods – drugs, folk remedies, and by surgery.
This method of treating inflammation of the veins in the legs involves the use of drugs both externally and internally.
Initially, inflammation of the veins of the lower extremities can be treated with drugs for external use, which are represented by a large assortment of ointments, gels, and creams. The drugs are applied to the diseased limb with massaging movements. Many of them tend to relieve swelling and inflammation, relieve pain, prevent blood clots, thin the blood, and strengthen the walls of the veins.
Oral medicines useful in the treatment of inflammation of the veins:
- non-steroidal anti-inflammatory drugs: Ketonal, Meloxicam, Dokloburn, Ketoprofen;
- medicines preventing stagnation of blood in venous vessels: Vasoket, Venosmin, Detralex, Actovegin, Trental;
- blood-thinning agents: Cardiomagnet, Aspirin;
- drugs that prevent the formation of thrombosis: Acetisalicylic acid, Clopidogrel;
- enzymes – Urokinase, Trypsin, Chemotrypsin.
Along with the prescribed oral medications, ointments or gels, the doctor can prescribe the passage of physiotherapy (electrophoresis, paraffin applications, magnetotherapy), as well as treatment with leeches.
By following medical recommendations, both superficial and internal processes of venous inflammation can be overcome.
Treatment of venous inflammation on the legs with folk remedies involves the use of improvised drugs. Traditional medicine is effective in the initial stages of venous inflammation in the legs and is often combined with drug therapy.Among the most effective means are the following:
- An excellent remedy for phlebitis – a net of iodine. The latter, penetrating into the tissues, relieves inflammation and numbes painful areas.
- Compresses of petroleum jelly and medical alcohol have proven their effectiveness – they help to relieve redness and puffiness.
- Water lotions with vinegar allow to cool the inflamed areas with varicose veins.
- Short ice compresses relieve the condition.
- Trays with green tea, coltsfoot, chamomile and mint have an anti-inflammatory effect.
- Effective in the fight against inflammation of the veins are the fruits and leaves of horse chestnut, from which a decoction is prepared, used in the form of compresses.
Specialists resort to surgical intervention in cases where the expected effect of treatment with medicines and folk remedies cannot be achieved.
Medical advice and prevention of pathology
Doctors recommend paying attention to such nuances.They are presented below:
- Venous vessels can become inflamed at any time of the year, but summer is the most favorable for the development of pathology. Hot weather conditions contribute to the disruption of the full blood circulation process. Often in the heat, there is an increase in pressure, characterized by an expansion of the walls of blood vessels. With their weak elasticity, swelling of the legs and hemorrhages appear. In case of phlebitis, it is not recommended to get sunlight on the legs.
- Vessels perform their function perfectly when a person is in active movement.Outdoor hiking can help prevent stagnation. But besides, you need to remember that the load on the legs should be non-fatiguing.
- Avoiding hormonal contraceptives improves circulatory health.
- It is useful to take blood-thinning agents, which must be prescribed by a specialist. You should not get carried away with self-treatment, only the doctor can identify the cause of the inflammation of the veins in the legs and help to effectively influence it in order to fully recover the patient.
- Quitting bad habits: drinking alcoholic beverages, smoking reduces the load on blood vessels.
- If you have varicose veins, you should undergo periodic examinations and courses of treatment.
- Since inflammation of the veins is more of an acquired disease, it affects people who work hard physically and representatives of sedentary professions. Therefore, due attention should be paid to systematic periodic medical examinations.
- A regular visit to a phlebologist at the slightest manifestation of symptoms of the disease allows you to make effective adjustments to the work of the cardiovascular system.
- In case of injuries to the extremities, you need to seek medical help in order to prevent the penetration of infections into the body and provoke venous inflammation.
- In addition, the prevention of phlebitis consists in wearing comfortable seasonal shoes made from natural ingredients with low heels.
Cured phlebitis means lightness in the legs, a full-fledged active life without pain and discomfort. Do not forget that inflammation of the veins is the initial stage of complex ailments of the cardiovascular system.Therefore, you do not need to risk your health and seek qualified medical help at the first symptoms.
What to do if a vein in your leg is inflamed? Link to main publication
Inflammation of veins in the legs: what to do, how to treat and how to relieve inflammation
Everyone should be aware that varicose veins is a serious disease that can provoke complications. Inflammation of the veins in the legs is called phlebitis, which is most often triggered by varicose veins.
This disease appears due to the ingestion of bacteria, infections, they lead to destructive phenomena in the vessels.
The disease, in turn, can give even more serious consequences – thrombophlebitis, it is characterized by the formation of blood clots and possible blockage of the vein.
What is phlebitis and its types
Doctors of the Russian Academy of Sciences told how to cure varicose veins in 5 days! Write down the recipe …
Veins are irreplaceable for the human body, they allow maintaining the health of the whole organism, since communication with the heart is achieved through the vessels, and the organs receive nutrition. With certain disorders in the vascular system, the formation of an inflammatory reaction is possible.
Phlebitis is characterized by inflammation of the vascular membranes, which provokes a slow meek, and in severe cases, an abscess or the formation of a blood clot is possible. There are many potential causes of the disease, but inflammation is usually triggered by streptococcal or staphylococcal infections.
Veins in the leg have such a structure that they consist of 3 layers of muscles: internal, middle and external.
Depending on the type of the affected area of muscle tissue, phlebitis is additionally divided into:
Often provoked due to external tissue pathology, for example, mechanical damage or trophic ulcers;
Additionally, vascular inflammation is divided depending on the depth of the vein:
Most often, the reason is the penetration of infection with varicose veins;
It is especially dangerous, as it can reach the lungs or heart when displaced, causing death.
Only the extremities can become inflamed; such a reaction does not occur on the internal organs. At the same time, phlebitis of the saphenous veins is diagnosed in 9 out of 10 registered cases.
Medical statistics indicate the occurrence of inflammatory processes mainly in the legs, for the hands the disease is very rare, but still possible.Most often, vascular damage in the hands occurs due to long-term treatment with droppers, injections, etc.
When placing a catheter, an infection can get into the arm, which will provoke inflammation.
Thrombophlebitis in the veins of the legs occurs due to common causes:
The primary sign that indicates the presence of an inflammatory reaction is the presence of pigmentation on the skin with a characteristic red tint. Usually, foci of redness are located along the damaged vessel from varicose veins. The symptoms are not limited to this, therefore, before prescribing treatment and diagnosing the disease, you should pay attention to:
The symptoms are even worse after a long rest, in the morning, when you have to get up, the symptoms are worse.
In the case of phlebitis, pain in the arm area often occurs, sensations are strong, localized at the injection site and begin to spread throughout the entire vessel.
At first, the skin turns reddish, over time the color changes to yellowish. The patient often complains of a sharp deterioration in health. The inflammatory process lasts 2-3 weeks.
In the case of inflamed veins and the classic course of thrombophlebitis, there are swelling in the legs and arms, the body becomes lethargic, painful sensations in the calf muscles are observed, the skin turns red.
During palpation, muscle tissue is noticeably thickened. If left untreated, the disease progresses rapidly and symptoms worsen, and the skin may eventually turn blue.
For the last stages of development of phlebitis, a change in the color of the skin over the vein to black or dark brown is characteristic.
Why venous inflammation is dangerous
Phlebitis of superficial veins can cause unwanted manifestations, although they are much easier than in deep vessels:
Phlebitis of deep vessels is an extremely dangerous disease that can cause serious complications:
The reason for these manifestations is a detached blood clot that has reached the heart or brain;
Lung embolism is a disease that poses a danger not only to health, but also to life.
Diagnosis of phlebitis
If the course of varicose veins is accompanied by inflammatory reactions, an urgent need to contact a phlebologist or vascular surgeon. Initially, a survey, examination and palpation of the extremities will be carried out, which will already allow a preliminary diagnosis to be determined. To confirm the guesses, you will have to go through some examinations:
What are the goals of phlebitis therapy?
Vein inflammation treatment involves the achievement of the following objectives:
If a vein becomes inflamed, then treatment should be prescribed on the basis of an integrated approach.
It is likely that the cured disease indirectly provoked phlebitis, since irritation, damage to the veins after injections on the hands is most common.
In this case, the treatment involves the elimination of discomfort. When it is found that the vessels are inflamed due to infection, it is initially necessary to kill pathogenic microorganisms in the body.
Only after eliminating the cause of the disease can one proceed to the therapy of thrombophlebitis.
It is recommended to treat inflammation of the veins in the legs and arms using conservative methods:
Regardless of which membrane the inflammation has struck, internal or external, drugs are recommended for use, which are divided into groups according to the effect they have.
Allow to eliminate painful manifestations, as well as the inflammatory response itself;
Varius, Heparin ointment, Troxevasin, Venobene, Voltaren;
The latest development of Russian specialists, has the fastest possible effect – after 1-2 courses, significant improvements come even at the advanced stage of varicose veins. The formula is based on native plant extracts, and therefore is dispensed without a doctor’s prescription. It is usually impossible to obtain a medicine with such a potent effect without a prescription.
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Opinion of doctors about the drug Read >>>
The duration of the course, dosage and regularity of use are prescribed by the attending specialist, who will draw conclusions based on the severity of the disease.
There is also a popular treatment for inflammation. To speed up the healing process, the following recipes are presented:
It is effective not only against inflammation, but also for the elimination of pain syndrome;
Preparation consists in mixing 2 tablespoons of boiling water into 0.5 liters. collection. Set aside the liquid in a thermos for 1 night. Use 100 ml 3 times a day. The course of treatment is about 6-7 weeks;
Use 100 g of leaves per 1 liter of sprinkle, but if the raw material is dried, then 50 g will be enough. Set aside the boiling water and insist until it cools.Consume 150 ml after meals for 2 months;
Crush dried leaves to a powdery state and add sour cream or kefir. Put the mixture on cheesecloth, a napkin will do, and wrap it over the affected area overnight. It takes 4-5 days to produce such compresses.
Alternative treatment often manifests itself as an auxiliary therapy or it replaces drugs, the use of which is prohibited on a long-term basis.
What treatment is prohibited for phlebitis?
Many patients today write off all treatment only to the use of compression hosiery. With the layering of inflammation, such therapy is not recommended, even contraindicated.
On the contrary, it is necessary to create maximum conditions for high-quality blood circulation and outflow of fluid from edematous extremities. Due to wearing compression underwear, it is possible for fluid to escape into the lumen of the vein and accelerate blood flow.
The situation is dangerous because the streptococcal pathogen, which is in the liquid, also enters the bloodstream and spreads it throughout the body.
The wearing of medical underwear is indicated only after the infection has cleared, and tests must be carried out to confirm this. Initially, the compression ratio should be low.
Possible complications if untreated
Complications in the treatment of phlebitis can often be irreversible and carry a certain risk to the patient’s health. Some forms can be fatal, which once again indicates the need for comprehensive and professional treatment.
Prevention: elevation of venous status
Today, genetic changes in the structure of the human body are not yet amenable to changes in medicine and science.Thus, it will be necessary to correctly use the vessels that have formed.
The patient needs to eliminate bad habits from life, especially smoking, which adversely affects the walls of blood vessels and the body as a whole.
Wearing shoes with high heels must be used wisely.
Excess weight is really bad for health, but more harm is noted from haphazard weight loss and the use of unhealthy diets. You need to see a doctor for help.
Only timely performed preventive measures are able to preserve the patient’s health and prevent ugly external manifestations. The ailment is serious, which should be treated immediately after symptoms are detected. In no case should you postpone treatment, as is the case with ordinary varicose veins.
Read also Varicose veins: causes of
Phlebitis of the lower extremities: symptoms, treatment, inflammation of a vein in the leg, what is
One of the complications of varicose veins on the legs is phlebitis – inflammation of the venous walls, resulting from the penetration of microbes / pathogenic organisms and leading to the destruction of blood vessels.
It threatens the development of thrombophlebitis, a dangerous blockage of blood vessels due to the separation of a blood clot in an inflamed vein.
In medicine, phlebitis of the lower extremities is distinguished, the symptoms and treatment of which will be discussed in this article.
What is the disease and its types
Vessels in the body perform a vital function – they connect all organs with the heart. Their damage leads to the onset of an inflammatory process.
With phlebitis of the lower extremities, the venous walls become inflamed, leading to a deterioration in blood flow, and in case of a complicated course – to an abscess or the formation of blood clots.
There are a lot of reasons provoking the pathology of the vascular walls, but among the most common are varicose veins, infections (usually strepto- / staphylococcal), inflammation of the vein due to injection.
Human veins are tubular formations consisting of three layers of muscle tissue – inner, middle and outer.
According to the type of damage to the vessel wall, phlebitis of the lower extremities is divided into the following types:
In medical practice, the name panphlebitis is more often used, diagnosing multiple damage to the vein, indicating which layer of the vascular walls is inflamed.
According to the localization of damaged vessels, the following types of vascular inflammation are distinguished:
These types of venous inflammation, localized on the extremities, are the most common. In 90% of cases, phlebitis of superficial veins is diagnosed.
How phlebitis manifests itself
Inflammation of the veins in the legs proceeds with features characteristic of any inflammatory process.
Acute form of phlebitis of superficial veins is characterized by the following features:
- Soreness and tension of the inflamed vessels;
- seal of the epidermis;
- pronounced hyperemia of the skin;
- an increase in body temperature is possible.
Also, in some cases, there is itching, swelling of the limbs, difficulty walking, less often convulsions occur. The patient feels the affected veins under the skin, which become like a rope as they harden.
The chronic form of phlebitis of the lower extremities, all the symptoms of which are smoothed out and do not manifest themselves brightly, proceeds with periodic exacerbations.
The following symptoms are characteristic of deep vein inflammation:
- pain syndrome and significant edema;
- pale milky color of the epidermis;
- severe fever;
90,029 cutaneous ulceration;
90,029 bruising on the leg.
This type of inflammation of the vascular walls is dangerous by the formation of blood clots and, accordingly, the transition to a complicated stage – thrombophlebitis.
In case of untimely treatment of inflammation of the veins in the legs, the symptoms will intensify: swelling, hyperemia will increase, cyanosis of the skin will appear, up to the acquisition of a dark brown (even black) shade.
If the above symptoms of phlebitis are found, it is necessary to make an appointment with a specialist phlebologist as soon as possible.
Why venous inflammation is dangerous
Superficial phlebitis threatens with deterioration of the condition and the development of pathologies such as:
- varicose veins – a consequence of thrombotic damage to the valves and stagnation of blood in the vessels – leads to an increase in superficial veins;
- discoloration and ulcerative lesions of the epidermis under the influence of the pressure of stagnant blood;
- development of obstructive phlebitis – blockage of a vein by a blood clot that interferes with venous circulation.
Deep vein inflammation leads to more serious health complications:
- myocardial infarction and hemorrhage can be a consequence of the formation of a blood clot in the heart or brain;
- Pulmonary embolism occurs when a blood clot blocks a pulmonary vessel, causing pulmonary embolism, a potentially life-threatening condition.
In order to prevent complications of venous inflammation, you should be attentive to your health and seek qualified help from a medical institution.
Diagnosis of phlebitis
If you have an inflamed vein, see your doctor immediately. He will conduct a visual examination, make a preliminary diagnosis. To confirm it, you will need an examination that includes diagnostic measures:
- blood test with a mandatory test for the presence of D-dimer, which promotes coagulation: an increased value indicates the presence of phlebitis;
- Ultrasound of deep veins of the lower extremities;
- echocardiography (Echo KG) with Doppler vascular diagnostics will detect the affected areas;
- venography – the introduction of a contrast agent under X-ray observation.
If studies have not revealed a complete picture of phlebitis of the lower extremities, computed / magnetic resonance imaging is additionally prescribed.
Treatment of inflammation of the veins in the leg
If the doctor has confirmed the diagnosis of phlebitis, it is necessary to strictly adhere to the prescribed therapeutic course. Self-medication of venous inflammation cannot be dealt with. Phlebitis threatens with serious consequences – disability, and in the aggravated stage – the death of the patient.
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The acute stage of phlebitis of the superficial veins of the lower extremities lasts from 7-10 days to one and a half months, deep vein inflammation – from 3 months to six months. The disease does not require inpatient treatment, since it is important to maintain physical activity to relieve symptoms. An exception is the aggravated course of phlebitis of the leg veins.
It is possible to treat phlebitis on the veins of the legs using conservative and surgical methods. Alternative medicine has proven itself well.Let us consider in more detail each of these principles for the treatment of phlebitis of the lower extremities.
Medicines relieve inflammation and prevent thrombus formation in case of superficial and deep phlebitis on the leg.
The following medicines are used:
Please note that the drug, their combinations, dosage and duration of treatment should be prescribed only by the doctor personally for each patient.
Ineffective treatment of phlebitis with medicines and other non-pharmacological methods leads to an operative method. The following surgical methods of eliminating inflammation of the venous wall are practiced:
If the treatment of venous inflammation is started on time, surgical intervention can be dispensed with.
However, if this procedure could not be avoided and the operation was performed, do not think that you have defeated vascular inflammation forever.
If you neglect the recommendations of doctors, do not take care of your legs and neglect your own health, the cured disease of the venous wall will return and flourish with renewed vigor.
Treatment with non-traditional methods
Non-pharmacological therapy for venous inflammation has many recipes based on natural herbal remedies to help with phlebitis.
Horse chestnut is very popular in the fight against inflammation of the veins in the legs. Benefit from powerful recipes based on this plant:
There are many other equally useful recipes:
In addition, for phlebitis of the lower extremities, the symptoms and treatment of which we spoke about, it is necessary to use an elastic bandage, compression stockings / tights. Physiotherapy is effective for venous inflammation, for example, methods such as drainage and pressotherapy.
Do not forget about moderate physical activity and proper nutrition. The main thing is not to neglect the recommendations of specialists. This will help not only to cure acute venous inflammation, but to avoid its subsequent development.
Inflammation of leg veins symptoms and treatment
Inflammation of the veins of the lower extremities
Inflammation of the veins (or phlebitis) is a rather serious disease of the blood vessels that occurs against the background of the inflammatory process in the superficial and deep veins.
The disease can develop both on the arm and in the lower extremities. The consequence of varicose veins in most cases is inflammation of the veins in the legs.
According to the recommendations of doctors, it is necessary to start treatment immediately in order to speed up the healing process and avoid the development of complications.
Types of phlebitis
In medical practice, depending on which veins are affected by the inflammatory process, two types of diseases are distinguished:
- Superficial phlebitis is an inflammation of the subcutaneous blood vessels.This type of ailment basically does not cause dangerous complications, provided that thrombophlebitis has not developed at the same time.
- Deep vein phlebitis (or thrombophlebitis) is a condition where inflammation of the blood vessels is caused by a blockage of the lumen of the vein by a blood clot (thrombus). A very dangerous type of ailment, since a blood clot can come off, and with the outflow of blood to get into the heart or pulmonary artery, further provoke death. It is the advanced stage of varicose veins that is the cause of the formation of blood clots.
Types of phlebitis
In order to prevent the occurrence of such dangerous complications, treatment should be started immediately. Phlebitis in the lower extremities, especially during an exacerbation, is so dangerous that urgent hospitalization is required.
As evidenced by medical data, inflammation of the walls of the veins develops mainly in the legs due to varicose veins. But it can also occur on the hand.
This is often due to long-term injection treatment (use of an intravenous catheter).Also, the inflammatory process in the vessels in the upper extremities can occur due to infection through the catheter.
Thrombophlebitis of blood vessels in the lower extremities occurs against the background:
- inactive lifestyle;
- leaking varicose veins of the legs;
- increased blood viscosity;
- chemical effects on a vein (for example, treatment of varicose veins with sclerotherapy).
90,029 genetic predisposition;
90,029 bad habits;
90,029 use of hormonal drugs;
90,029 hits of infection;
The first sign of the development of inflammation of the superficial veins is the appearance of red spots on the skin, which are located along the pathological process of the blood vessel. In addition to skin discoloration, the following symptoms of phlebitis of the lower extremities exist:
- increase in body temperature;
- slight soreness and itching;
- formation of small wounds along the affected vessel;
- Feeling of heaviness in the legs.
Symptoms of the disease are aggravated after a night’s sleep when the person gets to their feet.
With the development of phlebitis on the hand, the patient experiences severe pain, from the injection site, the skin over the affected vein first turns red, and after a certain period of time it becomes yellowish.
The patient has a significant deterioration in his general health. The duration of the inflammatory process is two to three weeks.
The classic symptoms of thrombophlebitis are swelling of the lower and upper extremities, general malaise (subfebrile condition), soreness in the calves, reddening of the skin in the affected area, during palpation, you can feel the compaction of soft tissues.If you do not start to treat the blockage of blood vessels, then the symptoms will only worsen.
The patient has increased edema, at the site of vascular occlusion and inflammation, the skin begins to turn blue. At the last stage of the progression of the disease, the skin in the affected area becomes dark brown (or black). At the first suspicion of venous inflammation, it is necessary to urgently consult a doctor and begin treatment so as not to aggravate the situation.
How thrombophlebitis manifests itself externally, you can see in the photo.
Symptoms of thrombophlebitis Therapeutic measures
If the onset of the disease is associated with the use of a catheter, then the patient must undergo a course of procedures, the purpose of which is to relieve pain.
In case of development of inflammation against the background of infection, therapeutic measures will initially be aimed at eliminating pathogenic bacteria, and only after that phlebitis will be treated in the area of the upper or lower extremities.
Treatment of venous inflammation can be carried out conservatively:
- medicinal drugs;
- by means of traditional medicine.
When treating phlebitis, the patient must be kept in bed, and the diseased limb must be in an elevated position to increase blood flow. Compresses should be applied to the affected area using ointments with anticoagulant and anti-inflammatory properties. When carrying out therapeutic measures, it is very important to choose the right medication.
Treatment of venous inflammation with hirudotherapy Drug therapy
Treatment of the disease is carried out with the following drugs:
- Non-steroidal anti-inflammatory drugs (Ketoprofen, Meloxicam, Ketonal, Ibuprofen, Diklobern).They relieve pain symptoms, eliminate the inflammatory process.
- Anticoagulants (Aspirin, Cardiomagnet, etc.). They have a blood thinning effect.
- Preparations that improve blood circulation and eliminate congestion (phlebotonics). Most often prescribed: “Actovegin”, “Venosmin”, “Solcoseryl”, “Venoplant”, “Trental”, “Detralex”, “Curantil”, “Vasoket”).
- Antiplatelet drugs (Clopidogrel, Acetylsalicylic acid, Dipyridamole).Prevents blood clots.
- Pharmacological agents for local use (“Heparin ointment”, “Troxevasin ointment”, “Thrombophobe”, “Venobene”, “Dolgit cream”, “Voltaren”, etc.)
- Preparations from the group of fibrinolytic enzymes (Chemotrypsin, Urokinase, Streptokinase, Trypsin, Fibrinolysin).
Drug therapy for venous inflammation Traditional medicine
Treatment using folk recipes can be carried out in conjunction with drug therapy.The most common method is an iodine grid. It effectively helps relieve painful sensations and eliminate the inflammatory process.
Compresses are very good at reducing and eliminating the inflammatory process. You can make a compress from buckwheat flour and pre-boiled and chilled cabbage leaves.
In order to remove redness on the skin in the area of the upper and lower extremities, it is recommended to make a compress based on petroleum jelly and medical alcohol.
Cold compresses with vinegar water help to eliminate the inflammation of varicose veins in the lower extremities. The compress is applied to the sore spot and secured with a woolen cloth or bandage.
Elimination of the inflammatory process with the help of a compress Prophylaxis
People with signs of varicose veins in the lower extremities belong to the group at increased risk of developing inflammation of the blood vessels.
They need to undergo regular medical examinations, and when the first signs of inflammation appear, begin to carry out therapeutic measures.
For a speedy recovery and prevention of the recurrence of the disease, it is recommended to observe the following rules:
- Stop drinking and smoking. It is very important to walk for short distances, this helps to eliminate congestion and thereby prevent the development of the process of thrombus formation.
- Move more.
- In case of varicose disease, you should regularly undergo a course of treatment.
- Timely conduct therapy for infectious diseases.
- If you are injured, even minor ones, you should immediately seek medical attention. Injuries can become a source of infection and provoke phlebitis of the blood vessels.
Hiking – prevention of the development of inflammation of the blood vessels
- If possible, you should limit the intake of drugs that have a detrimental effect on the venous walls. This is especially true of drugs to avoid unwanted pregnancy.
- As a prophylaxis, take blood thinning drugs.
Phlebitis is an unpleasant but effectively treatable disease. If you seek help from a doctor in a timely manner, then the ailment will not have a detrimental effect on the human body and will allow you to completely recover in a short period of time.
90,000 causes, symptoms and treatment in the article of the vascular surgeon I. N. Illarionov
Date of publication December 10, 2019 Updated April 26, 2021
Definition of the disease.Causes of the disease
Phlebitis is an inflammation of the venous vessel wall, often occurring against the background of varicose veins and accompanied by the formation of thrombosis. This condition is called “superficial vein thrombophlebitis” or “varicothrombophlebitis”. Phlebitis is also a common complication of peripheral intravenous therapy, which is carried out through a venous cannula (catheter) – taking venous blood and intravenous infusion  .
Various studies have identified many risk factors for phlebitis.They can be divided into several groups: causes of phlebitis related to patients, cannula, prescribed therapy, and other factors   .
The most common risk factors associated with a patient are age, gender, and comorbid conditions. The incidence of phlebitis increases with age: most studies have shown that overt signs of phlebitis were present in about 50% of patients over 60 years old  . It was also found that phlebitis most often occurs among women, but there is still no satisfactory explanation for this statistics   .In addition, conditions that impair circulation (peripheral vascular disease, smoking), sensitivities (peripheral neuropathy), and diabetes mellitus  increase the risk of phlebitis.
For reasons associated with the intravenous cannula, include the physicochemical properties of the material and its size  . Most often, the development of phlebitis is influenced by cannulas made from Teflon derivatives, for example, fluoroethylenepropylene copolymer.
Other risk factors for the development of phlebitis are associated with the tolerance of the injected solutions.It depends on the pH of the drug, its osmolarity (concentration of kinetically active particles) and the rate of injection into the vein. The likelihood of phlebitis is significantly increased if the pH and osmolarity of solutions differ from those of the patient’s blood  . Also, the risk of developing phlebitis increases the use of antibacterial drugs, mainly from the group of beta-lactams, due to their high activity  .
If you find similar symptoms, consult your doctor.Do not self-medicate – it is dangerous for your health!
At the site of the lesion, you can feel a painful, compacted, tense area of the inflamed vein. The pain is of a different nature and occurs along the course of the vein immediately with the development of phlebitis. The skin in the area of inflammation becomes hyperemic (reddened), the temperature of the affected area rises.
In rare cases, with the development of phlebitis of the upper limb, numbness occurs. Swelling of the hand is usually not observed.Sometimes this process is accompanied by a general deterioration in well-being, the development of weakness, malaise.
With phlebitis of the dorsal vein of the penis, redness, induration, swelling and sharp pain along the course of the vein are also observed. The penis becomes bluish in color.
With phlebitis of the veins of the brain, a constant headache occurs, blood pressure rises, neurological symptoms appear – visual impairment.
Inflammation of the portal vein is characterized by severe purulent intoxication.The patient’s condition worsens, weakness, vomiting, headache, cutting pains in the right hypochondrium, jaundice, fever are possible. There is a danger of death.
Pathogenesis of phlebitis
The outer cell layer of the vein is called adventitia . It is an elastic membrane, contains a large number of collagen fibers that form the vein framework, and a number of muscle fibers located along its bed. In the middle – muscle – vein sheath has the largest number of smooth muscle fibers.They are located spirally around the lumen of the vessel and enclosed in a network of coiled collagen fibers. With a strong stretching of the vein, the collagen fibers are straightened, and its lumen increases. The inner cell layer is called intima . It consists of endothelial cells as well as smooth muscle and collagen fibers.
The inflammatory process in phlebitis can begin both in the outer and in the inner layer of the vein. The mechanism of development of pathology can be associated with one of the reasons:
- external trauma;
- internal direct endothelial trauma;
- inflammation of the vein wall;
- primary blood clotting disorder.
External trauma can result from direct external impact due to blunt trauma or external dressings  . The vein is compressed, the width of its lumen is disturbed. As a result, blood flow slows down, which leads to the development of thrombosis and phlebothrombosis, and local long-term exposure provokes the appearance of local phlebitis. A decrease in the rate of blood flow and venous stasis is also observed with visible varicose veins and local external damage – trophic ulcers.
Inner wall damage includes direct disruption of adventitia cells. It activates the same inflammatory response as external trauma, with similar consequences. The injury is often associated with routine intravenous procedures, including phlebotomy (dissection of a vein) and intravenous fluids through a catheter (action of solutions, injury to veins from needles).
The timing of the placement of the catheter in the vein is related to the rate at which inflammation appears. The longer he is there, the higher the risk and rate of development of phlebitis, as well as the likelihood of a bacterial infection, during which purulent superficial venous thrombosis may occur.
In addition, the infusion of hypertonic solutions can directly damage the endothelium. This is usually the case for diazepam and pentobarbital. They can cause chemical inflammation that disrupts the normal functioning of the vein and leads to blood clots around the catheter tip, secondary infection and sepsis. Also, infusion of fluids in the area with slower venous return is more likely to lead to thrombosis of superficial veins.
Classification and stages of development of phlebitis
Depending on the cause, phlebitis is divided into large groups:
- Phlebitis, which has arisen against the background of varicose veins.
- Phlebitis not associated with varicose veins – most likely caused by genetic disorders of blood coagulation:
- Post-injection phlebitis – develops as a result of chemical irritation of the vein by the injected solution or mechanical trauma. Most often it is accompanied by the appearance of pain along the vein and at the site of the catheter, as well as the presence of redness.
- Allergic phlebitis – develops due to a vein’s reaction to an allergen (drug, catheter material).The symptoms are similar to post-injection phlebitis.
According to the location of the inflamed vein , the following types of phlebitis are distinguished:
- Phlebitis of the penis is associated with varicose veins or an infectious disease (for example, gonorrhea). Causes redness and swelling of the skin, the formation of a volumetric painful induration on the dorsum of the penis .
- Portal vein phlebitis (or pylephlebitis) is associated with a complicated course of inflammatory processes in the abdominal cavity (cirrhosis of the liver, pancreatitis, Budd-Chiari syndrome, etc.)). Differs in signs of purulent intoxication. Can lead to death.
- Cerebral phlebitis – develops in the veins of the brain against the background of infection or purulent inflammation (abscess or phlegmon). It manifests itself as a constant headache, increased blood pressure, visual impairment.
- Phlebitis of the veins of the upper extremities – in the area of the lesion on the arm, pain appears, redness of the skin, a cord-like thickening of the vein is observed.
- Phlebitis in the basin of the small saphenous vein – accompanied by muscle tension, pain and redness of the skin, fever and the appearance of stripes along the inflamed vein .
- Phlebitis in the basin of the great saphenous vein is similar in manifestations to phlebitis of the small saphenous vein.
- Migratory phlebitis – develops in the veins of the legs, is characterized by a long recurrent course, more common in young men. It can also affect the walls of the arteries. When migratory thrombophlebitis is associated with cancer, it can occur years before diagnosis. It is manifested by the appearance of redness, induration, and tightness along the vein in various parts of the body.
Phlebitis can also be classified by pathophysiology :
- Primary phlebitis is a direct inflammation in the veins.
- Secondary phlebitis is a systemic inflammatory process. This group includes septic thrombophlebitis – inflammation of a vein that occurs during infection.
According to the site of localization of inflammation in the vein , three forms of the disease are distinguished:
- endophlebitis – inflammation of the inner lining of the vein;
- periphlebitis – inflammation of the outer membrane of the vein;
- Panphlebitis – inflammation of all vein membranes  .
Complications of phlebitis
The main complication of phlebitis is venous thrombosis – the formation of a blood clot in the lumen of a vein.The incidence of this disease at the age of 40 and earlier is approximately one case in 10,000 people per year; after 45 years, the incidence increases and by the age of 80 it reaches 5-6 cases per 1000 people per year  . The reasons for the increased risk of thrombosis with age are not entirely clear, but may be associated with the presence of diseases of the cardiovascular system, liver and other organs that increase coagulation (blood clotting).
The incidence of venous thrombosis is slightly higher in men than in women.About two-thirds of the episodes manifest as deep vein thrombosis. The main outcomes of venous thrombosis are reoccurrence of blood clots, post-thrombotic syndrome, severe bleeding due to thinning drugs, and death.
Thrombosis leads to a deterioration in the quality of life, especially with the development of post-thrombotic syndrome, which is accompanied by chronic edema of the limb, discoloration of the lower leg skin, trophic disorders   . Death occurs within one month after the episode in about 6% of patients with deep vein thrombosis and in 10% of patients with embolism – blood clots entering the vital organs  .In 30% of cases, a person dies from thromboembolism even before the diagnosis is  . Mortality rates are lower among patients with venous thrombosis that occurs without an obvious cause and are highest among those who develop thrombosis in the setting of existing oncology.
Phlebitis can also contribute to the development of infectious complications such as abscess and phlegmon. Both conditions can be fatal.
In the center of the superficial abscess , the skin becomes thinner, sometimes appears white or yellow due to “ripe” pus inside, ready to spontaneously break through.With deep abscesses , local pain, fever, weight loss, fatigue are typical.
Phlegmon is a painful swelling with diffuse redness of the skin. It develops rapidly, accompanied by a high temperature (40 ° C and more), disruption of the affected part of the body. When it spreads to the surrounding tissues, phlegmon can provoke the development of purulent arthritis, tendovaginitis and other purulent diseases.
Diagnostics of phlebitis
Local phlebitis can be found directly in the area of an indwelling venous catheter or when questioning the patient when it turns out that this area was injured or the drug was injected into it  .
Patients with suspected superficial venous thrombosis and phlebitis should have duplex ultrasound scan . If you suspect phlebitis of the penis, you need to undergo ultrasound examination of vessels of the penis and scrotum.
Also, all patients need to assess the likelihood of developing pulmonary embolism and deep vein thrombosis. For this, the Wells scales and the Geneva classification are used. They take into account age, previous illness and surgery.With a high score, it is required to perform computed tomography of the lungs to exclude pulmonary embolism.
Patients with catheter-associated peripheral venous thrombosis of the upper extremities, or minor phlebitis caused by direct trauma, may not require duplex ultrasound scanning due to the presence of subcutaneous inflammation and the possibility of making a diagnosis clinically, i.e. for signs of the disease. The extent of superficial thrombosis with assessment of deep vein thrombosis should be documented.
Some patients require laboratory tests to detect hypercoagulability – changes in blood clotting – or to confirm cancer, especially when superficial venous thrombosis is not associated with a catheter or varicose veins. Hypercoagulation is detected using a coagulogram , sometimes a hemostasiogram. If deviations from the norm in the direction of increase or decrease are detected, , consultation with a hematologist is required to jointly determine the tactics of further diagnostics.This score is influenced by signs of the disease, risk factors, and family history of the disease. In some cases, it may include simple screening for hereditary thrombophilia or more extensive cancer or vasculitis screening (as recommended by a rheumatologist)   .
Treatment of phlebitis
Most patients with phlebitis are treated symptomatically with anti-inflammatory drugs and compression. It is aimed at reducing pain and inflammation, preventing complications and relapses.Treatment depends on the site of inflammation, the presence of concomitant acute deep vein thrombosis and varicose veins.
Duplex ultrasound scanning of the extremity is important at an early stage of treatment, especially for phlebitis associated with local varicose veins, an intravenous catheter or other device. If the study confirms the presence of varicose veins and reflux (backflow of blood), then these patients can initially be treated without surgery  .With the progression of the disease into the deep venous system, a decision is made on surgical treatment or anticoagulant therapy.
For the treatment of patients with spontaneous thrombosis of superficial veins, prophylactic or intermediate doses of low molecular weight heparin or intermediate doses of unfractionated heparin are used. They must be applied for at least four weeks.
Surgical removal of the vein is performed for recurrent cases of superficial venous thrombosis  .The vein must be removed if phlebitis occurs at least a second time.
After treatment, patients are advised to use compression hosiery. The period of wearing is determined by the attending physician
With a timely visit to a vascular surgeon, the prognosis of phlebitis is relatively favorable, especially with phlebitis of the upper extremities – it passes almost without a trace. Hirudotherapy (treatment with leeches) can lead to a sharp progression of the disease due to trauma to the vascular wall.
If the inflammation has spread to the deep vein system, treatment takes longer. Subsequently, develops post-thrombotic disease . In 5-10% of cases, it leads to disability, a decrease in the quality of life and the preservation of permanent limb edema.
The main prevention method is to maintain physical activity, especially when traveling. Sitting on a long flight or car trip can lead to swelling of the ankles, calves and increase the risk of thrombophlebitis.To prevent thickening of the blood in these cases, it is worth walking down the aisle once an hour. For a long drive, you need to stop every hour and drive for 10-15 minutes. It is worth performing venous gymnastics: bending the ankles or lifting and lowering the shins on the socks at least 10 times an hour.
You should try to wear loose clothing that does not tighten your shins, drink plenty of fluids to avoid dehydration. When taking hormonal contraceptives, you should undergo a triplex ultrasound scan once a year and be observed by a gynecologist   .