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Phlebitis: Causes, Symptoms, Diagnosis & Treatment

Phlebitis is a condition which causes inflammation of the vein. If the inflammation is caused due to a blood clot, it's called thrombophlebitis and if the blood clot is deep inside the vein, it's called deep vein thrombosis (DVT).

Types Of Phlebitis

1. Superficial phlebitis - It is the inflammation of veins near the surface of the skin, resulting from a blood clot. This type of phlebitis requires treatment, and is rarely serious.

2. Deep phlebitis - It is the inflammation of a deeper, larger vein mostly caused due to a blood clot. Larger blood clots can develop, which may break off and travel to the lungs, that can lead to a condition called pulmonary embolism [1] .

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What Causes Phlebitis

Phlebitis is caused either by an injury or irritation in the lining of a blood vessel.

Superficial phlebitis may be due to a small blood clot, placement of an IV catheter [2] , an infection, or the use of irritating medicines into your veins.

  • Deep phlebitis is caused due to the following reasons:
  • Injury in the deep vein caused by trauma such as surgery, broken bone, or serious injury.
  • Excess of blood clots more than usual, due to medications, connective tissue disorders, cancer, or inherited blood clotting conditions.
  • Slower blood flow due to lack of motion.

Symptoms Of Phlebitis [3]

The symptoms mostly appear in the arms and legs which include the following:

  • Swelling
  • Redness
  • Tenderness
  • Warmth
  • Visible red streaking on the arms and legs
  • Rope-like structure that you can feel through the skin

If phlebitis is caused by deep vein thrombosis (DVT), you may notice pain in your calf or thigh.

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Risk Factors Of Phlebitis [4]

  • A history of DVT
  • Birth control pills or hormone therapy
  • Blood clotting disorders
  • Pregnancy
  • Obesity
  • Smoking
  • Misusing alcohol
  • Prolonged inactivity
  • Sitting for longer periods
  • Above 60 years of age

Complications Of Phlebitis

The complications aren't that serious, but phlebitis can lead to infection of the surrounding skin, wounds on the skin, and bloodstream infections.

The most common and serious complication of deep vein thrombosis (DVT) is pulmonary embolism. The symptoms of pulmonary embolism include chest pain, coughing up blood, unexplained shortness of breath, rapid breathing, fast heart rate, and feeling light-headed.

Diagnosis Of Phlebitis

The diagnosis of phlebitis is based on the symptoms and a physical examination conducted by your doctor. If a blood clot is the primary cause of phlebitis, the doctor will perform several tests after examining you.

The doctor may then conduct an ultrasound of your affected limb and assess your D-dimer level, a blood test that checks for a substance released in the body when a blood clot dissolves.

If the ultrasound doesn't show any positive result, the doctor may perform venography, MRI scan, or CT scan to check for blood clots. After the blood clot is detected, the doctor will take blood samples to test for blood clotting disorders.

Treatment Of Phlebitis [5]

The treatment for superficial phlebitis includes warm compresses, removal of an IV catheter, or antibiotics if an infection is suspected.

For treating deep vein thrombosis (DVT), you may need to take anticoagulants. If DVT is causing any further serious problem, a thrombectomy is done, where a surgeon inserts a wire and catheter into the affected vein and either removes the clot or dissolves it with medications that help in the breakdown of blood clots.

If you have deep vein thrombosis and are at higher risk for pulmonary embolism, insertion of a filter into one of your major blood vessels may be recommended. These filters are removable and won't prevent any blood clots from forming, but it will prevent blood clots from travelling to the lungs.

Permanent filters cause complications like infection, life-threatening damage to the blood vessels, and enlargement of blood vessels around the filter.

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Prevention Of Phlebitis

  • Wear compression socks
  • Stretch your legs often while sitting for longer periods
  • Drink plenty of water while travelling
  • After surgery, get up and walk around
  • Take blood thinning medications as instructed by doctors
View Article References
  1. [1] Kesteven, P., & Robinson, B. (2001). Superficial thrombophlebitis followed by pulmonary embolism.Journal of the Royal Society of Medicine,94(4), 186–187.
  2. [2] Urbanetto, J., Peixoto, C. G., & May, T. A. (2016). Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal.Revista latino-americana de enfermagem,24, e2746.
  3. [3] Mihala, G., Ray-Barruel, G., Chopra, V., Webster, J., Wallis, M., Marsh, N., ... & Rickard, C. M. (2018). Phlebitis signs and symptoms with peripheral intravenous catheters: incidence and correlation study.Journal of Infusion Nursing,41(4), 260-263.
  4. [4] Milutinović, D., Simin, D., & Zec, D. (2015). Risk factor for phlebitis: a questionnaire study of nurses' perception.Revista latino-americana de enfermagem,23(4), 677–684.
  5. [5] Litzendorf, M. E., & Satiani, B. (2011). Superficial venous thrombosis: disease progression and evolving treatment approaches.Vascular health and risk management,7, 569–575.

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