1. Thrombophlebitis
By: BILAL AL-LAMI

2. Objectives Definition Risk factors Pathophysiology Signs and symptoms
Diagnosis
Deferential diagnosis
Treatment
Complications

3. Definition
Thrombo means “clot” phlebitis means “inflammation of the vessel”.
Thrombophlebitis occurs when a blood clot causes inflammation in a vein. Blood clots typically forms in the legs or pelvis.
Formation of venous clot depends on the presence of virchow’s triad factors.

4. Risk factors

5. Trauma, travel
Hypercoagulability, hormone replacement
Iv drugs
Old (more than 60)
Malignancy
Obesity, obstetrics
Surgery, smoking
Immobilization

6. Pathophysiology
Most common cause of hereditary hemophilia is factor V Leiden
Thrombi usually form at the venous cusps of deep veins where altered or static blood flow causes clot formation
Alternatively, clots form from intimal defects
Clots are composed from fibrin, red cells and platelets and cause partial/complete obstruction of vein
Postphlebitic syndrome (PPS) may develop after the resolution of a DVT
PPS is due valvular incompetence, persistent outflow obstruction and abnormal microcirculation.

7. Signs and symptoms Pain in the part of the body that is affected
Warmth
Tenderness
Fever
Skin redness and inflammation
Swelling(edema)of the extremities

8. Diagnosis

9. Physical examination –doctor will look for any swelling, dis-colouration and soreness in the affected area.
Ultrasound – This allows the doctor to watch and monitor the blood flow ensuring that there are no blood clots present and the overall flow of the blood is not being constrained or restricted.
Blood tests –doctor will check for the presence of D-Dimer, a small protein fragment that is present in the blood of all DVT sufferers.
Venography – An X-ray test that involves injecting dye into a vein to show how blood flows through the veins. This will allow the doctor to determine the condition of veins. 
Computerized tomography (CT) or magnetic resonance imaging (MRI) scans – These are imaging techniques which portray high resolution images of the veins. doctor may use these techniques to show if there is a clot present.

10. Differential diagnosis
Post traumatic(hematomas adjacent to the vein)
venous puncture.
intravenous drug abuse
Allergic reaction to insect bite
Lymphangitis
Cellulitis
Erythema nodosum
erysipelas

11. Treatment

12. BE ACTIVE
Elevate the legs
Warm cloths
Drugs
Support socks
NSAIDS
Drink lots of water
Salicylates (natural blood thinners)

13. Complications
Extremely painful ulcers may form on the skin close to the varicose vein particularly near the ankles.
If the blood clot dislodges this may leads to PE

14. References
    Hingorani A, Ascher E. Superficial venous thrombophlebitis. In: Gloviczski P, ed. Handbook of Venous Disorders. 3rd ed. Oxford, England: Oxford University Press; 2009:

15. THANK YOU