Skip to Main Content

+

  • • Can occur spontaneously in varicose veins, pregnant or postpartum women, thromboangiitis obliterans, Behçet disease

    • Most common after IV therapy, area of local trauma

    • Superficial migratory phlebitis (Trousseau): Suggests abdominal carcinoma

    • Pulmonary embolism (PE) is rare without deep venous thrombosis (DVT)

++

Epidemiology

+

  • • Saphenous vein most common vein affected

    • 20% of patients have simultaneous DVT

++

Symptoms and Signs

+

  • • Local extremity pain, redness

    • Indurated, erythematous, tender areas = thrombosed superficial veins; tends to be well localized over superficial vein

    • Firm cord may develop with time

    • Generalized edema absent unless deep veins involved

    • Fever or chills suggests septic or suppurative phlebitis (complication of IV cannulation)

++

Rule Out

+

  • • Ascending lymphangitis

    • Cellulitis

    • Erythema nodosum

    • Erythema induratum

    • Panniculitis

+

  • • Physical exam

    • CBC

+

  • • Primary treatment: NSAIDs, heat, elevation, support stockings, elastic wrap

    • Ambulation encouraged

    • Anticoagulation with monthly venous duplex can be attempted to avoid surgery

++

Surgery

+

  • • Excision of vein if persists > 2 wks or recurrent

    • Ligate and resection vein at junction of saphenofemoral or cephalic-subclavian junction

    • Septic thrombophlebitis: Broad-spectrum antibiotics; if patient is septic, immediate excision of infected vein

++

Indications

+

  • • > 2 wks duration or local recurrence

    • Septic patient

++

Treatment Monitoring

+

  • • Usually resolves in 7-10 days; is self-limited

++

Prognosis

+

  • Uncomplicated superficial thrombophlebitis: Responds well to conservative therapy

    • Extension into DVT associated with PE

++

References

Di Nisio M et al: Treatment for superficial thrombophlebitis of the leg. Cochrane Database of Syst Rev 2007;2:CD004982.
Lucia MA et al: Images in clinical medicine: superficial thrombophlebitis. N Engl J Med 2001;344:1214.  [PubMed: 11309636]
Sullivan V et al: Ligation versus anticoagulation: treatment of above-knee superficial thrombophlebitis not involving the deep venous system. J Am Coll Surg 2001;193:556.  [PubMed: 11708514]

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessSurgery Full Site: One-Year Subscription

Connect to the full suite of AccessSurgery content and resources including more than 160 instructional videos, 16,000+ high-quality images, interactive board review, 20+ textbooks, and more.

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessSurgery

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.