Phlebitis is an inflamed vein (or varicose vein) on the surface of the skin. Phlebitis is also known as phlebitis. Veins are wide blood vessels with weak walls that ensure the return of blood from the organs to the heart. If a blood clot causes the inflammation, it is called thrombophlebitis. When the blood clot is in a deep vein, it is called deep vein thrombosis or DVT, also known as leg thrombosis. Deep vein thrombosis can cause serious complications and requires immediate treatment with blood thinners. Phlebitis refers to inflammation of a vein and this can be caused by any damage to the blood vessel wall, reduced venous blood flow or clotting abnormality. Pain, swelling, redness and tenderness are some common symptoms of phlebitis. Simple measures can be taken to prevent phlebitis.
- What is phlebitis?
- Types of phlebitis
- Superficial phlebitis
- Deep phlebitis
- Superficial thrombophlebitis
- Deep vein thrombosis
- Symptoms of phlebitis
- Cause of phlebitis
- Risk factors for inflamed veins
- Trauma or injury
- Prolonged immobility
- Hormones
- Smoking
- Obesity and overweight
- Certain cancers
- Recent surgery
- Examination and diagnosis
- Treatment of phlebitis
- Prognosis and recovery
What is phlebitis?
The simple definition of phlebitis is an inflamed vein or phlebitis. Phlebitis most commonly occurs in the leg veins and often resolves spontaneously after a few days to weeks.
Types of phlebitis
Different types of phlebitis are distinguished.
Superficial phlebitis
Superficial phlebitis is an inflamed vein (or varicose vein) on the surface of the skin. There is inflammation and clot formation in a superficial vein and it usually affects the superficial veins in the legs, but sometimes also those in the groin. This inflammation is usually not serious and heals quickly.
Deep phlebitis
Deep vein phlebitis affects a deeper, larger vein. This usually happens in the legs, but can also occur in the arms.
Superficial thrombophlebitis
A superficial vein thrombosis (OVT) is a blood clot plus vein swelling in a vein near the skin surface. There is a blockage by clotted blood of the superficial draining veins in the leg.
Deep vein thrombosis
Deep vein thrombosis or DVT refers to a blood clot plus vein swelling in a deep vein, usually in the leg. Deep vein thrombosis is the most serious type of phlebitis. If the blood clot breaks away from its location in the arm or leg and travels to the lungs, it can cause a fatal condition called pulmonary embolism.
Symptoms of phlebitis
The symptoms of phlebitis include:
- pain, redness and swelling
- the vein feels like a cord or string
- visible red ‘stripes’ on your arm or leg
- itching and irritation
- throbbing or burning sensation
- lumps or a swollen area on your skin
- (sometimes) mild fever
Worsening of symptoms occurs when you get out of bed, bend the nearest joints, or lower your leg instead of raising it. Usually these symptoms develop slowly. However, some people notice that they develop these symptoms soon after having a needle or an IV in their arm.
Cause of phlebitis
Phlebitis has many causes. Some common causes of phlebitis include:
- local trauma or injury to the vein (due to an IV, wound or surgery)
- prolonged inactivity or immobilization, for example during long car journeys or plane trips, plaster
- insertion of intravenous catheters or a peripheral infusion
Varicose veins / Source: Zlikovec/Shutterstock.com
- period after surgery (postoperative period), especially orthopedic procedures
- prolonged immobility, such as in hospitalized or bedridden patients
- varicose veins
- underlying cancers or clotting disorders
- disruption of the drainage of the normal venous system due to removal of lymph nodes, for example after mastectomy for breast cancer
- intravenous drug use
- patients with burns
There are roughly three possible conditions that can lead to phlebitis:
- a slowed blood flow due to varicose vein disease or prolonged immobilization
- a damaged vein wall due to local trauma
- increased tendency to clot (which is seen with smoking, obesity, hereditary clotting disorders, use of the pill, obesity and cancer, etc.).[1]
Risk factors for inflamed veins
There are several possible risk factors for felebitis.
Trauma or injury
One of the most common risk factors for phlebitis is trauma. For example, trauma or injury to the arm or leg can cause injury to the underlying vein, resulting in inflammation or phlebitis.
Prolonged immobility
Prolonged immobility is another common risk factor for phlebitis. Blood in the veins of the lower extremities is normally pumped to the heart by the contraction of the muscles of the lower leg. If muscle contraction is limited due to prolonged immobility from sitting in an airplane or car, the blood in the veins can stagnate and clot formation can occur, which can result in thrombophlebitis.Pregnancy is a risk factor for thrombophlebitis / Source: Zerocool, Pixabay
Hormones
Hormone therapy, birth control pills, and pregnancy all increase the risk of developing thrombophlebitis. These hormonal influences cause an increased tendency to clot. An increased tendency of the blood to clot is called thrombophilia.
Smoking
Smoking is another risk factor for thrombophlebitis. Smoking increases the tendency of the blood to clot. Smoking in combination with contraceptive pills can significantly increase the risk of thromboembolic disorders (thrombosis and embolism).
Obesity and overweight
Obesity is also a risk factor for thrombophlebitis. It increases the blood’s tendency to clot. Increased body size increases the production of clotting factors and platelet activation. At the same time, fibrinolysis decreases; this is the process by which a blood clot is slowly broken down. Obesity can also cause damage to the walls of the veins, so-called endothelial damage, and slowed blood flow in the lower limbs (venous stasis).[2]
Certain cancers
Certain cancers are known to increase the risk of clot formation by causing abnormalities in the normal clotting system. This can lead to phlebitis or thrombophlebitis.
Recent surgery
Recent surgeries of any type can be associated with phlebitis. The greatest risk appears to be with major orthopedic treatments and cancer treatments.
Examination and diagnosis
Phlebitis can be diagnosed based on the presenting symptoms and a physical examination. No additional testing may be necessary. If a blood clot is suspected as the cause of phlebitis, the doctor may perform various tests and examinations. The doctor may order an ultrasound of the affected limb. An ultrasound uses sound waves to visualize the blood flow through your veins and arteries. Blood tests may also be useful. If the ultrasound does not provide a clear picture, the doctor can also perform a venography. In this procedure, X-ray or MRI images are made of the veins after a special dye (contrast fluid) has been injected into the blood.Medication for phlebitis / Source: Stevepb, Pixabay
Treatment of phlebitis
Treatment of superficial phlebitis may include removal or relocation of a catheter or IV, warm compresses, or antibiotics if an infection is suspected. Conventional treatment of phlebitis consists of administering anti-inflammatory drugs, such as ibuprofen. It may also consist of one of the following treatments, depending on the cause of the phlebitis:
- Blood-thinning medications such as aspirin, enoxaparin and/or warfarin may be given to break up blood clots or to allow blood to flow more easily through the veins. These medicines ensure that blood clots less easily (anticoagulant medicine).
- Antibiotics may be necessary in case of a skin infection.
- Warm compresses, leg or arm elevation, and compression stockings may be recommended to ease symptoms such as swelling and pain.
- Surgery can be done in severe or chronic cases.
If you have a blood clot, you may need to stay in the hospital for a few days. People with superficial phlebitis can usually go home after the examination and receive treatment advice from the doctor.
Prognosis and recovery
In cases of superficial inflammation, phlebitis can often be treated at home after examination and assessment by a doctor. The treatment usually lasts one to two weeks. However, if complications arise or there is a more severe form of phlebitis, recovery may take longer.Notes:
- Doctor Tomberghmans. Superficial phlebitis. https://www.doktertomberghmans.be/ treatments/surfacekige-flebitis/ (accessed on 29-11-2021)
- Pfizer. Prophylaxis during gastric bypass or gastric bypass. https://www.pfizer.nl/antistolling-thrombose/prophylaxe-bij-een-maagverkleining-gastric-of-bypass (accessed on 29-11-2021)
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