phlebitis

Phlebitis: description

By a phlebitis one understands one localized inflammation of the vein wall, Often it occurs on the superficial veins of the legs, less often there is a phlebitis on the arms. Phlebitis can cause a blood clot. Conversely, a phlebitis may develop from a thrombosis. One distinguishes a superficial thrombophlebitis from an inflammation of the deep veins. It is virtually always associated with thrombosis and is therefore also referred to as deep vein thrombosis or phlebothrombosis. The distinction is important because the therapy and the course of the disease of the two forms differ.

Superficial phlebitis occurs more frequently in connection with varicose veins (varices, varicosis) because the vein wall changes here. Varices form predominantly on the legs, a phlebitis in the leg is therefore a frequent localization. Overall, phlebitis occurs relatively often. They should always be treated by a doctor as they can lead to complications if left untreated.

Phlebitis: symptoms

The symptoms of phlebitis are usually quite characteristic. Often, typical signs of inflammation occur: The affected vein section hurts and is characterized as a red, often swollen strand on the skin from. Overall, the respective limb is usually not swollen. In superficial phlebitis, the skin above the affected vein also feels much warmer. Even slight pressure on the inflamed vessel causes pain. If the thrombophlebitis is caused by a bacterial infection, it may be accompanied by fever.

In deep venous thrombosis of a leg or pelvic vein, the following symptoms occur:

• Drawing pain and feelings of tension in the affected leg
• Bluish-red discoloration of the skin and more prominent emergence of the vessels in the area of ​​venous thrombosis
• Pain on pressure on the inflamed vein
• Pain in the calf, especially when the toe is pulled up, or when pressed against the heel
• possibly fever

At the first signs of phlebitis, it is important to see a doctor so that it can be treated as soon as possible. In addition, only the doctor can distinguish a superficial phlebitis from a deep vein thrombosis. This is important because deep venous thrombosis can lead to serious complications. For example, if the blood clot breaks loose from the vein, it is flushed with the bloodstream to the heart and then to the lungs. There it finally clogs a blood vessel and it comes to a life-threatening pulmonary embolism.

Phlebitis: causes and risk factors

A phlebitis can have different causes. Often, slowed blood flow is a cause of thrombophlebitis, for example, in people with varicose veins, Here the vein wall is morbidly dilated so that the blood in the affected vein docks back. As a result, the so-called platelets, which play an important role in the blood coagulation, easily clump together – it creates a blood clot that further inhibits blood flow. As a result, there are inflammatory reactions in the vein wall. In addition, the risk of phlebitis increases due to prolonged standing or sitting as blood flow is restricted.

Often, too mechanical causes involved in the development of phlebitis. It can occur, for example, if the vein is compressed for a long time due to tight clothing, tight garter cuffs or hard chair edges.

After surgery, prolonged bed-rest or taking hormonal contraceptives (such as the pill) – especially in connection with smoking – the coagulation readiness of the blood increases. Therefore they are considered as risk factors for thrombophlebitis.

Also a so-called indwelling catheters is a common cause of phlebitis. This short, flexible plastic tube brings the doctor usually in a vein on the arm or hand, rarely on the head. As a rule, the venous catheter remains there for several days. It serves as a vascular access for drugs or infusions and is mainly used in hospitals. If the vein wall is injured when inserting the venous catheter or bacteria enter the vein via it, this can lead to phlebitis. The same applies to a blood sample or if the doctor injects a drug into the vein.

A special form of thrombophlebitis is the so-called thrombophlebitis migrans (“migrare”, Latin: wander). This phlebitis appears again and again in different parts of the body, apparently for no apparent reason. In some cases, this form of phlebitis may indicate a malignant disease, but sometimes no cause can be found.

Phlebitis: examinations and diagnosis

To diagnose the phlebitis, the doctor first asks about the medical history (Anamnese). He asks, for example, whether previously has already occurred a phlebitis, or if there is a varicose vein disease. Also, information about taking certain medications, such as the pill, are important to the doctor.

As part of the physical examination the doctor looks at the affected limb. He often recognizes a superficial phlebitis at first sight. The affected vein is characterized as a red, thickened strand on the skin surface. Careful scanning of this area causes pain.

Usually there is also one Ultrasound examination (sonography) the inflamed vein. In a phlebitis, the vessel wall is visibly thickened. Using a so-called Doppler sonography, the blood flow within the vessel can be displayed in color. This allows the physician to detect flow obstacles such as a blood clot.

If there is a suspicion of deep venous thrombosis, further examinations are usually necessary for the diagnosis. These include, among other things, a blood test and possibly an imaging vascular imaging by means of computed tomography or magnetic resonance tomography (CT or MR phlebography).

Phlebitis: treatment

The treatment of phlebitis depends on its type and severity. In case of superficial thrombophlebitis, the doctor advises first to inflamed area cool, In many cases, he also puts on a compression bandage. In the case of phlebitis, most people also find it pain-relieving when they lift their legs up. However, unless the doctor speaks against it, you do not have to keep to bed rest and may move as usual.

Helpful against the pain and the inflammation are drugs from the group of so-called non-steroidal anti-inflammatory drugs, such as the active ingredient diclofenac. The product is applied in ointment form to the inflamed vein, but it is also available in tablet form for oral use. In a recent thrombophlebitis, the doctor sometimes also removes the blood clot via one or more Punctures in the vein (Incision). Bacterial infections in phlebitis can be treated with antibiotics.

In some cases, when a phlebitis occurs, a blood clot forms near a branch into a deeper vein. In this case, medicines are used which inhibit blood coagulation, for example heparin.

If varicose veins are the starting point for phlebitis, their treatment may be followed in the second step.

For the treatment of deep vein thrombosis is usually a hospitalization necessary. Here, the treatment aims primarily to prevent pulmonary embolism. Doctors administer anti-coagulant drugs.

Phlebitis: Prevention

You can not prevent phlebitis, but there are some measures you can take to reduce the risk of phlebitis. Also includes:

• Let’s treat varicose veins.
• Avoid standing for long periods or sitting; If this is not possible, do foot exercises to stimulate blood flow in the legs.
• Stop smoking – especially for women taking the pill.
• Do not wear clothes that are too tight or tight, especially on the legs.
• Drink enough water. Dehydration thickens the blood, increasing the risk of blood clots.

Venous catheters should no longer remain in the vessel as necessary. If you are wearing it, watch for changes to the vein and tell your doctor immediately.

Phlebitis: Disease course and prognosis

Superficial thrombophlebitis, which is treated early, usually returns without complications. If, on the other hand, a thrombus develops near a junction with a deeper vein, a superficial vein thrombosis may also develop. This is associated with a higher health risk, as it may cause a pulmonary embolism, when the blood clot dissolves. The forecast at one phlebitis So depends on their extent and the time of treatment.