Introduction
Venous inflammation, also known as thrombophlebitis superficialis in medical terminology, is the inflammation of a superficial vein. Among other things, this is caused by damage to the venous valves in the area of the blood vessel. Especially long periods of sitting and immobility, as well as smoking, can lead to an accumulation of inflammation of the veins.
The phlebitis can be accompanied by a blood clot (thrombus) localized in the vessel. Such a clot is frequently observed in connection with phlebitis, but it does not necessarily have to be present in every case. A phlebitis is typically spatially limited, i.e. localized only in a certain section of the vein.
In most cases (about 90%) thrombophlebitis superficialis affects a blood vessel of the legs. Patients complain of redness and swelling in the area of the leg veins. They are often painful under pressure and also painful when moving. Often rest and raising the leg is good for the patient.
Causes
The cause of an inflammation of a vein is in most cases a slowing down of the blood flow through this vessel. Increased standing of the blood (at a slower flow rate) often leads to small blood clots, which lie inside the vein as a kind of foreign body and can subsequently trigger an inflammatory reaction. Such a reduction in the speed of the blood flow is given, for example, in the case of very pronounced varicose veins (varicose veins), but also in patients who are bedridden or have a heart condition.
Another conceivable cause for the development of phlebitis is the reverse: in the first step, an inflammatory reaction of the vessel wall occurs. This can be triggered, for example, by minor or major injuries to the vein (trauma) or by chronic inflammatory diseases. In any case, the puncture of a vein by medical personnel should also be considered as a possible cause of injury and thus source of inflammation.
Due to this inflammation, a thrombus then develops in the vessel in a second step. Most thrombophlebitis can be explained by one of the two explanations mentioned above. Other rather rare diseases are also known as possible causes: If a patient suffers from very frequent phlebitis that changes its location without varicose veins being visible, it could be thrombophlebitis migrans (Latin for migratory phlebitis), which can occur in the context of the so-called paraneoplastic syndrome (often in pancreatic cancer or the small cell form of lung cancer).
More frequent than this special case, but still rare, is thrombangitis obliterans, which is a typical phlebitis, especially in its early stages. However, in this disease, which is characterized by intermittently migrating inflammation of the blood vessels due to the body’s own immune complexes, the patient group immediately catches the eye: almost all patients suffering from this disease are male, between 20-40 years old and heavy smokers. The exact cause of thrombangitis obliterans is still unclear.
A combination of various genetic factors and smoking as a trigger is assumed. Finally, the so-called Mondor’s disease should also be mentioned as a conceivable cause; this is a strand-like thrombophlebitis superficialis, which occurs after an injury or infection and is usually localized on the trunk. Arm/lower arm As already described, an injury to the vein, e.g. through puncture or other trauma, is also possible as a cause.
Especially in the area of the arm, phlebitis triggered by doctors or other medical personnel is relatively common among the causes, since the forearm is easily accessible for blood samples or other things and the veins of this area are usually used for diagnostic steps or therapeutic measures. Indwelling venous cannulas or catheters, which may have to remain in the vein for a longer period of time to allow infusions or the administration of medication, are also often attached to the patient’s arm. Although the material for such intravenous catheters is of course sterilely packaged and everyone will make every effort to work hygienically and carefully, the foreign material will always remain foreign material and is therefore a potential source of infection for invading bacteria or other pathogens.Unfortunately, thrombophlebitis superficialis occurs repeatedly in the area of the forearm, which is due to a bacterial infection.
Of course, it cannot be strictly ruled out that other causes of phlebitis in the arm may also trigger phlebitis. However, the vein irritation unintentionally caused by medical products may not be avoidable under certain circumstances. You can find more information on this topic at: The phlebitis in the arm.
Phlebitis in the arm often occurs after infusions. We therefore also recommend the following: Phlebitis after an infusionAfter a simple blood draw without an additional intravenous cannula, a pronounced phlebitis rarely occurs. In most cases, the indwelling cannula inserted in the same step is the factor that irritates and irritates the vein.
Pain that occurs in the area of the puncture after a blood sample has been taken is usually caused by acute injury to the skin and the vessel or by a small bleed that has not yet stopped. Bruises (haematoma) that may occur at the puncture site are also sometimes extremely painful. If there are risk factors for the development of phlebitis (varicose veins, strong tendency to thrombosis), on the other hand, a blood sample may be only the drop that makes the barrel overflow and triggers thrombophlebitis superficialis. In the case of frequent or unusual phlebitis, a more detailed investigation of the cause should therefore be carried out.
