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Superficial thrombophlebitis

Definition

Thrombophlebitis is a swollen or inflamed vein due to a blood clot. Superficial refers to veins just below the skin's surface.

Causes

This condition may occur after injury to the vein. It may also occur after having medicines given into your veins. If you have a high risk for blood clots, you may develop them for no apparent reason.

Risks for thrombophlebitis include:

• Cancer

• Deep vein thrombosis

• Disorders that involve increased blood clotting (may be inherited)

• Infection

• Liver disease

• Pregnancy

• Sitting or staying still for a prolonged period

• Use of birth control pills

• Swollen, twisted, and enlarged veins (varicose veins)

Symptoms

Symptoms may include any of the following:

• Skin redness, inflammation, tenderness, or pain along a vein just below the skin

• Warmth of the area

• Limb pain

• Hardening of the vein

Exams and Tests

Your health care provider will diagnose this condition based mainly on the appearance of the affected area. Frequent checks of the pulse, blood pressure, temperature, skin condition, and blood flow may be needed.

Ultrasound of the blood vessels helps confirm the condition.

If there are signs of an infection, skin or blood cultures may be done.

Treatment

To reduce discomfort and swelling, your provider may recommend that you:

• Wear support stockings, if your leg is affected.

• Keep the affected leg or arm raised above heart level.

• Apply a warm compress to the area.

If you have a catheter or intravenous (IV) line, it will likely be removed if it is the cause of the thrombophlebitis.

Medicines called nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed to reduce pain and swelling.

If clots in the deeper veins are also present, your provider may prescribe medicines to thin your blood. These medicines are called anticoagulants. Antibiotics are prescribed if you have an infection.

Surgical removal (phlebectomy), stripping, or sclerotherapy of the affected vein may be needed. These treat large varicose veins or are done to prevent thrombophlebitis in high-risk people.

Outlook (Prognosis)

This is usually a short-term condition that does not cause complications. Symptoms often go away in 1 to 2 weeks. Hardness of the vein may remain for much longer.

Possible Complications

Complications are rare. Possible problems may include the following:

• Infections (cellulitis)

• Deep vein thrombosis

When to Contact a Medical Professional

Contact your provider if you develop symptoms of this condition.

Also contact your provider if you already have the condition and your symptoms worsen or do not get better with treatment.

Prevention

In the hospital, swollen or inflamed veins can be prevented by:

• The nurse regularly changing the location of your IV line and removing it if swelling, redness, or pain develop

• Walking and staying active as soon as possible after surgery or during a long-term illness

When possible, avoid keeping your legs and arms still for long periods. Move your legs often or take a stroll during long plane trips or car trips. Try to avoid sitting or lying down for long periods without getting up and moving about.

References

Haghshenas J, Haut ER. Venous thromboembolism: prevention, diagnosis, and treatment. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:1182-1185.

Wasan SM. Superficial thrombophlebitis and its management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 151.

Weitz JI, Eikelboom JW. Venous thrombosis and embolism. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 68.

Review Date: 5/10/2024

Reviewed By: Neil Grossman, MD, Saint Vincent Radiological Associates, Framingham, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.