Thrombophlebitis saltans I82.1

Very rare, strand-like "jumping" superficial thrombophlebitis (see also Mondor's disease), which, among other things, is also considered a monitoring early symptom of an occult visceral tumor (e.g., pancreatic carcinoma - C25.8) (facultative paraneoplastic syndrome). Unlike varicophlebitis, it also affects primary non-varicose veins.

Probably hypercoagulatory (allergic-hyperergic), thrombotic vascular reaction.

Most commonly, this segmental inflammatory phlebitis is observed in the setting of thrombangitis obliterans. It may also occur in isolation. Other triggers may include:

• Chronic bacterial focal infections
• Carcinomas (especially pancreatic carcinoma; also carcinomas of the lung and prostate; tumors can express cysteine proteinases that directly activate factor X and thus increase thrombin production ) - Note: this constellation seems to be rather rare!
• Behçet's disease
• Malignant lymphogranulomatosis and leukoses.

Occurring mainly in men. Thrombophlebitis saltans is a partial symptom of thrombangiitis obliterans.

A "jumping", acute, stranded, well palpable, painful thrombophlebitis is observed, running in phases over different vein sections; the phlebitic strands are 4.0-10.0 cm long. Short-term temperature increases during the thrust are possible. The changes heal spontaneously after 2-3 weeks with slight hyperpigmentation.

Cause search and remediation, smoking ban, tumor exclusion.

A special form of thrombophlebitis saltans is Mondor's disease, which affects the veins on the lateral wall of the throax.

1. Koushk-Jalali B et al (2020) Thrombophlebitis migrans. Dtsch Ärztebl Int 117: 125
2. Varki A (2007)Trousseau's syndrome: multiple definitions and multiple mechanisms. Blood 110:1723-1729