thrombophlebitis and phlebothrombosis.pptx

blood vessel conditions

1. 1 THROMBOPHLEBITIS AND PHLEBOTHROMBOSIS SYED MASOOD

2. DEFINITION: Phlebothrombosis is the term applied when thrombosis occurs in the deep veins in the absence of any inflammatory reaction in the veins. It is commonly referred to as Deep Venous Thrombosis. 2

3. DEFINITION: Thrombophlebitis is the term applied when thrombosis occurs in veins with inflammatory reaction in the vein, the thrombosis being secondary to that inflammation. Such thrombosis usually occurs in close time-relationship to infection of the surrounding tissues or, occasionally, trauma to the vein concerned. 3

4. AETIOLOGY of PHLEBOTHROMBOSIS: In 1856, Virchow identified three predisposing factors – Slowing of the bloodstream Changes in the vessel wall Changes in the blood itself Phlebothrombosis is more likely to occur in those who suffer from congestive cardiac failure 4

5. Cont. those who are immobile following surgery (especially abdominal surgery) those who are obese those who have varicose veins those who are taking a contraceptive pill 5

6. AETIOLOGY of THROMBOPHLEBITIS: Conditions which may be associated with thrombophlebitis are: Trauma to the vein concerned. Thrombophlebitis Migrans in which multiple venous thromboses occur, usually in superficial veins although deeper ones may be involved. 6

7. Cont. Frequently, the cause is unclear but often there is an association with carcinoma , particularly of the pancreas, breast or stomach Tropical thrombophlebitis . Outbreaks have been reported in Africans. The cause is unknown and thrombosis is widespread, often with involvement of the visceral veins. 7

8. Cont. Infective thrombophlebitis . This may be secondary to middle ear sepsis, suppurative osteomyelitis and bronchiectasis . In such lesions, the thrombi themselves become infected and detached fragments cause pyaemia. 8

9. Cont. Conditions in which there is bacteraemia , notably typhoid fever. It is thought that circulating organisms settle in the intima of the veins and produce an acute endophlebitis with secondary thrombosis. 9

10. Cont. Any condition which causes irritation and inflammation of the vein wall may produce secondary thrombosis. 10

11. PATHOLOGY OF PHLEBOTHROMBOSIS: 11

12. PATHOLOGY OF THROMBOPHLEBITIS: 12

13. CLINICAL MANIFESTATIONS of PHLEBOTHROMBOSIS: The deep veins of the calf are those most frequently affected. In a typical case, the leg is swollen and oedematous and is usually warmer than the opposite leg. The calf is tender and painful on dorsiflexion of the foot (Homan’s sign) . The superficial veins may be prominent. 13

14. Cont: Aching or cramp like pain at site of thrombus. Tenderness on deep palpation. May be symptomless. Unexplained features like: Pyrexia Pleuritic pain Tachycardia 14

15. CLINICAL MANIFESTATIONS of THROMBOPHLEBITIS: Localized, reddened, warm area with hard, cord like swelling along course of affected vein. Pain at rest and inc during movement. As condition resolves the skin become pigmented along the course of the vein. 15

16. of PHLEBOTHROMBOSIS: PREVENTION: Early postoperative mobilisation is most imp factor in prophylaxis. General breathing exercises. Active movements of hip, knees and ankle. Anticoagulant therapy. 16

17. TREATMENT: Treatment with i.v . heparin infusion produces immediate anticoagulation. The affected limb is firmly bandaged. Oral anticoagulants like warfarin are started. These are continued till 6 months to reduce risk of subsequent DVT or phlebothrombosis . 17

18. of THROMBOPHLEBITIS: Firm elastic bandaging or stockings from the toes to beyond the upper limit of affected area. DRUG THERAPY: Antibiotics in case of infection. Analgesics to relieve pain. Anti-inflammatory like indomethacin . 18

19. EXERCISE: patient should encouraged to Carry out foot exercises with legs elevated. To remain ambulant. 19

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