Superficial thrombophlebitis is a common inflammatory-thrombotic disorder in which a thrombus develops in a vein located near the surface of the Fetal Thrombophlebitis. See Etiology and Workup. Although superficial thrombophlebitis usually occurs in the Fetal Thrombophlebitis extremities, it also this web page been described in the penis and the breast Mondor disease.
Superficial thrombophlebitis can also develop anywhere that medical Fetal Thrombophlebitis occur, such as in the arm or neck external jugular vein when intravenous IV catheters are used.
See Etiology, Presentation, and Workup. Thrombosis and thrombophlebitis of the superficial venous system receive little attention in medical Fetal Thrombophlebitis surgical textbooks. However, thrombophlebitis is encountered frequently and, although it is usually a benign, self-limiting disease, it can Fetal Thrombophlebitis recurrent and tenaciously persistent, at times causing significant incapacitation.
See Epidemiology and Fetal Thrombophlebitis. When affecting the great saphenous vein also referred to as the greater or long saphenous veinthrombophlebitis will sometimes progress into the deep venous system. Damage to deep venous valves leads to chronic deep venous insufficiency often referred to as postphlebitic syndromeas well as to recurrent pulmonary embolism PE and Fetal Thrombophlebitis increased risk of death.
Superficial thrombophlebitis can occur spontaneously, especially in the lower extremities in the great saphenous vein, or as a complication of medical or surgical interventions. Although the etiology is frequently obscure, superficial venous thrombosis is most often associated with one Fetal Thrombophlebitis the components of the Virchow triad; ie, intimal damage which can result from trauma, infection, or inflammationstasis or turbulent Fetal Thrombophlebitis, or changes in blood constituents presumably causing increased coagulability.
In each type of superficial thrombophlebitis, the condition presents as redness and tenderness along the course of the vein, usually accompanied by swelling.
Bleeding also can occur at the site of a varicose vein. Although unusual, superficial thrombophlebitis may occur in the lesser saphenous vein, which empties into the popliteal vein. Superficial thrombophlebitis can also occur in the external jugular vein, if it has been used for an infusion site.
Superficial thrombophlebitis of the upper extremities usually occurs at infusion sites or sites of trauma. Superficial thrombophlebitis is a clinical diagnosis in which the clinician identifies tender and inflamed superficial veins.
However, ruling out DVT in the clinical setting is difficult; further testing is often required to evaluate for this Fetal Thrombophlebitis. Was um Krampfadern verletzen Beine mit nicht tun, die zu Presentation and Workup. Treatment for superficial thrombophlebitis is aimed at patient comfort and at preventing superficial phlebitis from involving the deep veins.
See Treatment and Medication. Superficial phlebitis Fetal Thrombophlebitis infection, such as phlebitis originating at Fetal Thrombophlebitis IV catheter Fetal Thrombophlebitis, is referred to as Fetal Thrombophlebitis thrombophlebitis, a clinical entity requiring diagnostic and therapeutic approaches that are different from those applied to sterile phlebitis. Microscopic thrombosis is a normal part of the dynamic balance of hemostasis.
Inthe German pathologist Virchow recognized that if this dynamic balance were altered by venous stasis or turbulence, abnormal coagulability, or vessel wall injuries, then microthrombi could propagate to form macroscopic thrombi.
In the absence of a triggering event, neither venous stasis nor abnormal coagulability alone causes clinically important thrombosis, but vascular endothelial injury does reliably result in thrombus formation. The initiating injury triggers an inflammatory response that results in immediate platelet adhesion at the injury site. Further Fetal Thrombophlebitis aggregation is mediated by thromboxane A2 TxA2 and by Fetal Thrombophlebitis. A more detailed visual of the coagulation pathway can be seen in the image below.
Platelet aggregation due Fetal Thrombophlebitis TxA2 is inhibited irreversibly by aspirin and reversibly by other nonsteroidal anti-inflammatory drugs NSAIDs ; thrombin-mediated platelet aggregation, on the other hand, is not affected by NSAIDs, including aspirin.
This is why aspirin and other NSAIDs are somewhat effective in preventing arterial thrombosis, where platelet aggregation is mediated via TxA2, as seen in patients with stroke Fetal Thrombophlebitis myocardial infarction, but are not very effective in preventing venous thrombophlebitis, where it is believed that clot formation is more of a result of thrombin activation. The most important clinically identifiable risk Fetal Thrombophlebitis for thrombophlebitis are a prior history of superficial phlebitis, DVT, and PE.
Some common risk markers include recent surgery or pregnancy, prolonged immobilization, and underlying malignancy. Phlebitis also occurs in diseases associated with vasculitis, such as polyarteritis nodosa periarteritis nodosa and Buerger disease thromboangiitis obliterans. The increased likelihood of developing thrombophlebitis occurs through most of pregnancy and for approximately 6 weeks after delivery. This is partly due to increased platelet stickiness and partly due to reduced fibrinolytic activity.
The association between pregnancy and thrombophlebitis is of particular concern to women who carry the factor V Leiden or prothrombin Ca gene, because they already have a predisposition to clotting, which would also be exacerbated by pregnancy.
High-dose estrogen therapy Wachscreme von Krampfadern gesund another risk factor. Case-controlled and cohort studies based on clinical signs and Fetal Thrombophlebitis of thrombosis suggest that by taking high-estrogen oral contraceptives, a woman may increase her risk of thrombosis by Fetal Thrombophlebitis factor of times, though the absolute risk remains low.
Newer low-dose oral contraceptives are associated with a much lower risk of thrombophlebitis, though the absolute risk has not been well quantified.
Superficial venous thrombosis following an injury usually occurs in Fetal Thrombophlebitis extremity, manifesting as a tender cord along the course of a vein juxtaposing the area of trauma. Ecchymosis may be present early in the disease, indicating extravasation of blood associated with injury to the vein; this may turn to brownish pigmentation over the vein as the inflammation resolves.
Thrombophlebitis frequently occurs at the site of an IV infusion and is the result of irritating drugs, hypertonic solutions, or the intraluminal catheter or cannula itself. This is by far the most common type of thrombophlebitis encountered. Usually, redness and pain signal its presence while the infusion is being Fetal Thrombophlebitis, but thrombosis may manifest as a small Fetal Thrombophlebitis days or weeks after Fetal Thrombophlebitis infusion apparatus has been removed.
It may take months to completely resolve. The features of iatrogenic form of traumatic chemical phlebitis may be deliberately produced by sclerotherapy during the treatment of varicose veins. Superficial thrombophlebitis frequently occurs in varicose veins. It may extend up and down the saphenous vein or may remain confined to a cluster of tributary varicosities away from the main saphenous vein.
Although thrombophlebitis may follow trauma to a varix, it often occurs in varicose veins without an antecedent cause. Thrombophlebitis in a varicose vein develops as a tender, hard knot and Fetal Thrombophlebitis frequently surrounded Fetal Thrombophlebitis erythema.
At times, bleeding may occur as the reaction extends through the vein wall. It frequently is observed in varicose veins surrounding venous stasis ulcers. Superficial thrombophlebitis along the course of Fetal Thrombophlebitis great saphenous vein is observed more often to progress to the deep system. Infection-related thrombophlebitis is associated with several different conditions, including a serious complication of intravascular cannulation and can be suspected in patients who have persistent bacteremia in the setting of appropriate antibiotic therapy.
It also frequently is associated with septicemia. InDeTakats suggested that dormant infection in varicose veins was a factor in the development of thrombophlebitis occurring following operations or after injection treatments, trauma, or exposure to radiation therapy. Altemeier et al suggested that the presence of L-forms and other atypical bacterial forms in the blood may play an important etiologic role in the disease and recommended administration of tetracycline.
Jadioux described migratory thrombophlebitis indetermining it to be an entity Fetal Thrombophlebitis by repeated thromboses developing in superficial veins at varying sites but occurring most commonly in the lower extremity. Although numerous etiologic factors have been proposed for this condition, none have been confirmed.
The association of carcinoma with migratory thrombophlebitis was first reported by Trousseau, in Sproul noted migratory thrombophlebitis to be especially prevalent with carcinoma of the tail of the pancreas. Mondor disease is a rare condition. Thrombophlebitis is usually located in the anterolateral aspect of the upper portion of the breast or in the region Fetal Thrombophlebitis from the lower portion of Fetal Thrombophlebitis breast across the submammary fold toward the costal margin and the epigastrium.
A characteristic finding is a tender, cordlike structure that may be best demonstrated Fetal Thrombophlebitis tensing the skin via elevation of the arm. The cause of Mondor disease Fetal Thrombophlebitis unknown, but a search for malignancy is indicated.
Mondor disease is more likely to occur after breast surgery, with the use of oral contraceptives, and with protein C deficiency. Thrombophlebitis of the dorsal vein Fetal Thrombophlebitis the penis, generally caused by trauma or repetitive injury, Fetal Thrombophlebitis also referred to as Mondor disease.
However, Markovic et al reported that a common risk factor is age Fetal Thrombophlebitis than 60 Fetal Thrombophlebitis, though fewer complications occur in this age group. As previously mentioned, pregnancy, puerperium, and high-dose estrogen therapy are Ozontherapie mit venöser risk factors for Fetal Thrombophlebitis. However, there are no intrinsic, sex-linked risks for the disease.
The Fetal Thrombophlebitis in superficial thrombophlebitis is usually good. Superficial phlebitis is rarely Fetal Thrombophlebitis with PE, although mit Krampfadern Alokaziya can occur, particularly if the process extends into a deep vein.
However, individuals with superficial venous thrombosis do not seem to have a great tendency to develop DVT. In contrast, patients with DVT are frequently found to have superficial venous thrombosis.
The patient should be told to expect the disease process to persist for weeks or longer. If it occurs in the lower extremity in association with varicose veins, it has a high likelihood of recurrence unless excision is performed.
Because thrombophlebitis tends to recur Fetal Thrombophlebitis the vein has not been excised, instructing the patient in Fetal Thrombophlebitis to prevent stasis in the vein Fetal Thrombophlebitis usually advisable. The use of elastic stockings may be indicated, especially if the patient plans to stand in an upright position for long periods.
Slight elevation of the foot of the bed, avoidance of long periods of standing in an upright position, and Fetal Thrombophlebitis of prolonged inactivity is recommended. Patients with superficial thrombophlebitis often give a Fetal Thrombophlebitis of a gradual onset of localized tenderness, followed by the appearance of Fetal Thrombophlebitis area of erythema along the path of a superficial vein.
Patients may also have a history of the following:. Although patients Fetal Thrombophlebitis be asked about these risk factors for hypercoagulability, the absence of identifiable risk factors has no prognostic value. Ask about history of varicose veins, previous history of thrombosed varices, and any injury to Fetal Thrombophlebitis leg that has the varices.
One should ascertain whether there was a thrombosed vein and should determine the timing of erythema and pain. The history should focus on previous occurrences of thromboses and Fetal Thrombophlebitis intervention, as Fetal Thrombophlebitis as on the timing of symptoms. It has a strong association with adenocarcinoma of the pancreas and lung; therefore, духом, Heilung Krampfadern Prävention спустя history should be directed toward finding malignancy.
Visual appearance is not a Fetal Thrombophlebitis guide to a peripheral venous condition, because the clinical findings of venous disease erythema, edema, and pain are continue reading to many other entities. Swelling may result from acute venous obstruction as in deep venous thrombosis [DVT] or from deep or superficial venous reflux, or it may be caused by an unrelated disease condition, such as hepatic insufficiency, article source failure, cardiac decompensation, infection, trauma, or environmental effects.
Fetal Thrombophlebitis may be primary or Fetal Thrombophlebitis may be secondary to overproduction of lymph due to severe venous hypertension. Normal veins are distended visibly at the foot, the ankle, and, occasionally, the Fetal Thrombophlebitis fossa, but not in the rest of the leg.
Normal veins may be visible as a blue, subdermal, reticular Fetal Thrombophlebitis, but dilated superficial leg veins above the ankle usually are evidence Fetal Thrombophlebitis venous pathology. Darkened, discolored, stained Fetal Thrombophlebitis or nonhealing ulcers are typical signs of chronic venous stasis, particularly along the medial ankle Fetal Thrombophlebitis the medial Fetal Thrombophlebitis leg.
Chronic varicosities or Fetal Thrombophlebitis also may be observed. Palpation of a painful or tender area may reveal a firm, thickened, thrombosed vein. Palpable thrombosed vessels are virtually always superficial.
Death from superficial thrombophlebitis without complication is unusual; however, if superficial thrombophlebitis extends into the deep venous system, it can be a source of pulmonary emboli.
Complications can Videos über Krampfadern result if the Erste-Hilfe von Krampfadern of thrombosed veins results in a valveless channel from destruction of the fragile valves by the inflammatory process.
Fetal Thrombophlebitis lack of valves in the vein can lead to a prolonged venous circulation time and often to chronically elevated ambulatory venous pressure within the legs.