Phlebitis: Symptoms and Treatment
Phlebitis is a vein disease in which inflammation of their vascular walls occurs. Most importantly, this disease for the lower extremities — phlebitis, the symptoms of which arise in this case, appears against the background of a topical for the patient varicose disease.
It is noteworthy that phlebitis often occurs in combination with concomitant diseases, such as thrombosis with subsequent development of thrombophlebitis. Thrombophlebitis is an inflammation of the vein in this variant, the course of which is accompanied by the appearance of thrombi. Thrombophlebitis is the most dangerous of the listed diseases, which is explained by the peculiarities of its inherent complications. By this means the possibility of detachment of the thrombus with its subsequent movement along the vessels. This, in turn, can cause a blockage of the pulmonary artery, which inevitably leads to a fatal outcome due to the occurrence of pulmonary embolism.
The development of thrombophlebitis determines the effect of two major factors, including increased blood viscosity, as well as a low tone seen in the vascular walls. These factors, in turn, determine the need for an integrated approach to the treatment of the disease we are considering.
Phlebitis and thrombophlebitis: causes of diseases
More often as a cause, provoking the development of phlebitis and thrombophlebitis, varicose veins are isolated. In addition, an important role is played by certain factors, such as overweight, hypodynamia (a condition provoked by a lack of motor activity), the length of stay in a standing position and constipation in the chronic form of the course of this disease.
The development of thrombophlebitis is also possible as a result of exposure to an allergic reaction, which determines such a variety as allergic phlebitis , in addition, the development of the disease and as a complication arising after Childbirth — in this case we are talking about painful phlebitis . Allergic phlebitis is characterized by a benign chronic course, phlebitis painful in acute form, accompanied by severity of pain manifestations. There are also cases in which thrombophlebitis occurs when the vein becomes infected or when it is injured, which implies a violation of integrity in its vascular wall.
Thrombophlebitis: the main types of disease
Based on the peculiarities of localization of the inflammatory process, inherent in the disease, the following varieties are distinguished:
- thrombophlebitis of the upper limbs ;
- thrombophlebitis of the lower extremities ;
- arterial thrombophlebitis (peripheral arterial thrombosis)
- thrombophlebitis of internal organs .
The appearance of the disease can also be noted in the area of the cerebral vessels, which determines cerebral phlebitis and in the collar vein area — in this case, it is actual pylephlebitis . In some cases, a variety of diseases such as phlebitis migrating, is observed, which involves the involvement of superficial veins in the process, both in the lower and upper limbs with a characteristic for this form of disease Defeat of the arteries. The course of the disease is characterized by duration, the disease as a whole is recurrent.
In addition to these options, the inflammatory process can also be characterized by varying degrees of localization with respect to the wall of the blood vessel. Thus, the lesion localized in the outer envelope of the vein determines the development of periphlete — this disease mainly develops due to the spread of inflammation outside the tissues surrounding the vein. If the inflammation is localized in the vein, that is, within its inner membrane, then the disease is defined as endophlebitis, if the inflammation occurs both on the inside and outside of the vein envelope — diagnose Panflebit.
With a complicated form of thrombophlebitis, which is septic thrombophlebitis , there is a purulent destruction of the thrombus with the simultaneous spread of blood through the blood vessels, that is, blood infection.
The most common variant of thrombophlebitis in the form in which it focuses on the lower extremities, and it is on it that we will dwell in more detail.
Lower extremity thrombophlebitis: symptoms
Among the main manifestations of thrombophlebitis in the region we are considering are the sharp pain that occurs in the calf muscles, the appearance of pain when trying to squeeze the hands of the muscles. In addition, there are also redness and swelling, and these are relevant not only for the legs, but also for the area under the eyes. The severity of symptomatic manifestations of thrombophlebitis is determined on the basis of the form in which this disease occurs, and also from the factor of the specific localization of thrombus development.
For example, thrombophlebitis of superficial veins of legs in its inherent symptomatology simply does not allow confusing this disease with any other. Predominantly the onset of the disease is noted with an already existing ailment of the disease in the form of varicose veins.
The most common type of thrombophlebitis is in the area of the large saphenous vein. The main symptom in this case is severe pain, which occurs in those places where this vein passes. In addition, there is an increase in temperature in the patient (from 38 and more degrees). Often there is an increase in lymph nodes. The places of passage of this vein are characterized by reddening and swelling of the skin. When probing the vein, you can determine that it is in a swollen and hardened state, while the probe itself causes painful sensations.
If deep vein thrombophlebitis develops, the symptoms of which concern, in particular, the lower leg, then they are the determining factor here the region of thrombus formation and the inherent dimensions. Basically deep vein thrombophlebitis is characterized by a pronounced onset, accompanied by severe pain, concentrated in the gastrocnemius muscle, in addition there is a feeling of swelling.
When trying to lower the leg down, there is an increase in pain. The patient has a fever, from the lower part of the indicated area the leg swells, «gets» and the skin — it acquires a characteristic blueness. After two days, a whole net of swollen veins appears in the lower part of the body, the palpation of the affected muscle is also painful for the patient. When the lower leg is compressed from the anterior and posterior sides, the patient, again, experiences pain, this phenomenon is defined as a symptom of Moses. It is noteworthy that compression from the right and left sides does not lead to the appearance of such painful sensations.
If the urgency becomes thrombophlebitis in the femoral vein, then in this case the symptoms are not so pronounced, respectively, they are less severe for the patient. Thus, a sensation of pain that arises from the area of the inner femoral surface is possible, in addition, the skin in the indicated area becomes swollen and reddened, swelling of the subcutaneous veins is observed.
Thrombophlebitis of the common femoral vein includes symptoms in the form of acute pain in the leg, while it turns blue and swells profusely. The patient also has fever and an increase in temperature. In the region of the top of the hip, as in the groin, the surface veins that have undergone swelling are prominent.
The most severe symptoms are accompanied by thrombophlebitis of the iliac-femoral tract of the main vein. In the event that the lumen of the vein is not completely blocked by the blood clot, the patient experiences not too pronounced pain, concentrated in the area of the sacrum and lower back, including one of the sides of the abdomen. In addition, there are complaints about worsening of health, a little increased body temperature. In the event that a thrombus is not attached to its wall in a given vein, thromboembolism may develop, which will act as the only symptom indicative of thrombophlebitis.
With the complete closure of the lumen of the vein with thrombus, the symptoms of thrombophlebitis manifest itself in the form of acute pain in the groin. The leg begins to swell, the tumor spreads to the groin, buttock and anterior abdominal wall.
Initially, the swelling to the touch is loose, but with the progression of the disease, its hardening is noted. The skin in the affected areas becomes cyanotic or, conversely, becomes white, in addition, against its background the veins show in a pronounced way. There is an increase in temperature (about 38-39 degrees), fever. The patient is very weak, he does not have the desire to move, there are also signs indicating self-poisoning of the body.
Deep vein thrombosis: symptoms
An even more dangerous disease is deep vein thrombosis , which is also referred to as phlebotrombosis. Symptom, as in other cases, depends on where the thrombus is located, and also on how much the lumen of the vein is blocked by it. And if thrombophlebitis of deep veins, the symptoms of which are sufficiently pronounced in the manifestations, leads to a certain alertness of the patient and simply a compulsory need to take measures regarding treatment, then deep vein thrombosis has a minimally painful syndrome, a slight bluish color and swelling.
The general reaction of the body, if manifested, is all just as insignificant, accompanied by a small temperature, weakness and slight malaise. Most often this disease is concentrated in the region of the shin and develops in those patients who are in bed. And although the clinic of deep thromboses, as you can see, has an erased character, deep vein thrombosis often breaks off, provoking thromboembolism of the pulmonary arteries. It is noteworthy that in the case of deep thrombosis the development of the disease in this variant occurs much more often than in the case of superficial thrombophlebitis.
Thromboembolism in the pulmonary artery is a fragmentary separation from the vein of the thrombus when it is later transferred through the blood flow to the pulmonary arteries. Based on the inherent thrombus size, the course of thromboembolism can occur with lightning speed, respectively, the lethal outcome occurs within half an hour.
If the thrombus is smaller, death in this case does not come so quickly. First, there is a large-scale disorder of blood circulation and respiration, after which already reanimation treatment is required. With thromboembolism affecting the branches of the pulmonary arteries, chronic heart failure and pneumonia develop.
Treatment of phlebitis and thrombophlebitis
Treatment of phlebitis, as well as thrombophlebitis, is carried out on an individual basis, for which a whole set of measures is applied: hirudotherapy, phyto- and reflexotherapy, physiotherapy in various variants, etc. Treatment of thrombophlebitis requires the use of elastic bandages and compression linen. With phlebitis of superficial veins, treatment can be performed on an outpatient basis, with the urgency of other localization options, patients are hospitalized.
In particular, the therapy provides for complete rest, as well as being in an elevated position. Appointed drugs that provide nutrition to the walls of the veins and contribute to reducing the level of viscosity of the blood. In addition, anti-inflammatory treatment is conducted at the general and local level.
To diagnose and prescribe appropriate treatment for suspected phlebitis or thrombophlebitis, it is necessary to consult a phlebologist.