diagram of blood clots

Blood Clots / Phlebitis

Blood clots in the veins of the legs are frequently called phlebitis or thrombophlebitis. This is a potentially dangerous condition that may affect any vein in the body but is most frequent in the lower extremity veins. Blood clots in the legs are frequent problems occurring in about 2 million extremities each year in the USA. Their seriousness varies from a minor nuisance to a serious threat to life and a leading cause of death.

Awareness of the potential for blood clots is important for everyone because they may be a risk to health and life. The symptoms of acute phlebitis are often very mild, and sometimes there are no symptoms at all. Swelling or pain in one leg that is not explained by other cause should be investigated promptly with an ultrasound examination. Early diagnosis and treatment results in safety for the immediate problem and prevention of death in nearly all cases; it also is the best way to minimize the late long-term effects on the lower leg.

DIAGNOSIS OF PHLEBITIS:

Blood clots can present as red tender lines on the legs or they can develop silently and grow extensively in the deep veins of the leg before being discovered. They are suspected by the physician when there is swelling or pain in just one leg that is not explainable by any other cause such as an injury or other events. The diagnosis requires an ultrasound examination for positive identification. This should be done for any extremity in which unexplainable symptoms of swelling or pain occurs.

Phlebitis occurs in superficial veins just under the skin or deep veins in the muscles of the legs. Superficial phlebitis is easily seen as an area of inflammation that is tender and red and swollen and feels usually like an oblong lump near the skin. It often occurs in legs that have varicose veins. This kind of phlebitis is easier to diagnose and less serious than phlebitis that develops in the deep veins where it has a high tendency to extend up and down the leg and give rise to pieces that break off and travel to the lungs.

In all cases, the diagnosis is made by ultrasound testing when one leg is enlarged or tender.

Modern ultrasound has provided an ideal method for diagnosing blood clots in the extremities. This test is called ‘duplex scanning’; it is painless, non-invasive, affordable, and widely available throughout the world. It provides an actual picture of the blood clot on a computer screen and has become the standard of care for diagnosing blood clots in the legs. When the diagnosis is made it is important to determine the length of the blood clot and the exact veins that are involved. If it is limited to the superficial veins just under the skin it is less dangerous than if it involves the deep veins buried in the muscles of the lower extremities. These are termed superficial thrombophlebitis and deep vein thrombosis respectively.

TREATMENT OF PHLEBITIS:

Management of superficial thrombophlebitis depends on the location and the length of the clot as well as the medical history of the patient. One should seek a vascular surgery consultation to determine what is the optimal treatment. Deep vein thrombosis in most cases warrant anticoagulation and can be treated with different types of anticoagulants, “blood thinner”. You should consult with the doctor for the right type of medication.