Phlebitis and Thrombophlebitis

  • Medical Author:
    Siamak N. Nabili, MD, MPH

    Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What causes phlebitis?

Phlebitis has many causes. Some of the common causes of phlebitis are:

  • local trauma or injury to the vein
  • prolonged inactivity, such as, long driving or plane rides
  • insertion of intravenous catheters (IV) in hospitals, or IV induced phlebitis
  • period after a surgery (post-operative period), especially orthopedic procedures
  • prolonged immobility, as in hospitalized or bed-ridden patients
  • varicose veins
  • underlying cancers or clotting disorders
  • disruption of normal venous system drainage because of removal of lymph nodes, for example, after mastectomy for breast cancer
  • intravenous drug use
  • patients with burns

What are the risk factors for phlebitis?

  • One of the common risk factors for phlebitis is a trauma. For example, a trauma or an injury to the arm or leg can cause an injury the underlying vein resulting in inflammation or phlebitis.
  • Prolonged immobility is another common risk factor for phlebitis. Blood that is stored in the veins of the lower extremities normally is pumped toward the heart by the contraction of the lower leg muscles. If the muscle contraction is limited due to prolonged (hours) immobility by sitting on a plane or a car, the blood in the veins can become stagnant and clot formation can result in thrombophlebitis.
  • Hormone therapy (HT), birth control pills, and pregnancy all increase the risk for developing thrombophlebitis.
  • Cigarette smoking is another risk factor for thrombophlebitis. Smoking in combination with birth control pills can substantially increase the risk of thromboembolism.
  • Obesity is also a risk factor for thrombophlebitis.
  • Certain cancers are known to increase the risk of clot formation (referred to as a hyper-coagulable state) by causing abnormalities in the normal clotting system (coagulation pathway). Some cancers with hypercoagulable state cause phlebitis or thrombophlebitis.
  • Inherited (primary) or acquired (secondary) hypercoagulable states are associated with an increased risk of phlebitis and thrombosis. Some, but not all, of these states can be identified by appropriate laboratory testing.
  • Recent surgery of any type can be associated with the conditions. The highest risk seems to come with major orthopedic procedures and procedures for cancers.
Medically Reviewed by a Doctor on 8/9/2016

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