DefinitionThis section has been translated automatically.
Phlebitis of a superficial varicose vein, usually in the context of a varicose vein disease.
Clinical featuresThis section has been translated automatically.
Very variable clinical picture, ranging from circumscribed findings in superficial side branches to partial or complete thrombosis of the vena saphena magna or parva. Clinically impressive are inflammatory reddened, overheated, considerably pressure-dolent, 1-3 cm wide or larger, possibly also branched, clearly palpable strands or plate-like infiltrates. Depending on the extent of the findings, there is an undisturbed or even restricted general condition with a clear feeling of illness and possibly subfebrile temperatures.
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Complication(s)This section has been translated automatically.
Accompanying deep vein thrombosis (DVT, see below phlebothrombosis) per continuitatem via perforating veins or via the sapheno-femoral or popliteal transition can occur. The frequency of DVT in varicophlebitis is reported up to 65%, the frequency of pulmonary embolism up to 33%.
TherapyThis section has been translated automatically.
Depending on the severity and extent of the findings.
General therapyThis section has been translated automatically.
- Mobilisation (let the patient walk) 3 times/day 30 minutes, nightly elevation, no anticoagulation.
Notice! Immobilization of the patient is contraindicated in thrombophlebitis!
- If possible incision and expression of the thrombus. For bedridden patients: compression bandage, elevation of the leg and low-dose heparinization.
External therapyThis section has been translated automatically.
Topical ointments containing heparin(e.g. Heparin-ratiopharm gel/ointment, Essaven cream), compression therapy with elastic short-stretch bandages (Pütter bandage), compression bandages that are self-adhesive on the thigh (e.g. Acrylastic, Tricoplast).
Internal therapyThis section has been translated automatically.
- Antiphlogistics such as acetylsalicylic acid (e.g. ASS 500) 3 times/day 500 mg p.o., diclofenac (e.g. Voltaren) 50 mg tbl., 2 times/day 1 tbl., indometacin (e.g. Indomet-ratiopharm Supp.) 1-2 times/day 1 Supp.
- If there is a risk of ascending thrombophlebitis of the great saphenous vein with localisation of the thrombus near the perforator or crusts: risk of deep vein thrombosis. Therefore, weight-adapted therapeutic heparinisation with e.g. nadroparin (fraxiparin) 2 times/day 0.1 ml/10 kg bw s.c., compression therapy (up to the groin), localisation and close monitoring of the process with ultrasound Doppler or phlebography and adjustment to an oral anticoagulant for 6 weeks to 6 months, emergency crossectomy if necessary. If a lysis therapy is considered, i.m. injections are contraindicated.
Progression/forecastThis section has been translated automatically.
Favorable; healing after 6-10 days.
LiteratureThis section has been translated automatically.
- Denzel C et al (2000) The diagnosis and therapy of progressive thrombophlebitis of epifascial leg veins. Ztbl Chir 126: 374-378
- Sieblist C et al (2010) Extensive pulmonary embolismsecondary
to varicophlebitis. Dermatologist 61:973-975. - Ströbel P (2010) Anatomy and pathological anatomy of the epifascial venous system. In: T Noppeney, H Nüllen Diagnosis and therapy of varicosis. Springer Medicine Publishing House Heidelberg S 10 -31
- Nüllen H et al. (2010) Complication of varicoseIn: T Noppeney, H Nüllen Diagnosis and therapy of varicoseIn. Springer Medicine Publishing House Heidelberg S 173-176
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Acetylsalicylic acid; Anticoagulants; Anti-inflammatories; Compression therapy; Crossectomy; Diclofenac; Heparins systemic; Heparins, topical; Indomethacin; Phlebitis; ... Show allDisclaimer
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Prof. Dr. med. Peter Altmeyer