A red, low-temperature cord in a superficial vein

Introduction The main feature of superficial venous thrombosis is pain in the site of thrombosis. The superficial veins have a red, low-heat cord, tenderness, and redness around. The embolus is not easy to fall off and generally does not cause pulmonary embolism. In addition, migratory superficial vein thrombosis is often a suggestive symptom of cancer. Superficial venous thrombosis: very similar to the clinical manifestations of thrombophlebitis, difficult to identify, and clinically superficial thrombotic venous disease is mostly thrombophlebitis rather than venous thrombosis, so the diagnosis of this type of disease is generally For thrombophlebitis.

Cause

(1) Causes of the disease

The disease is divided into two types: infectious and non-infective.

Infectious people are more common in acute infection, childbirth, pelvic or abdominal surgery, non-infectious people are caused by blood stasis, and more common in the posterior vein of the calf.

(two) pathogenesis

The calf venous return pressure is reduced due to various reasons, blood viscosity and platelet increase, and blood coagulation is increased. When the blood vessel is slightly damaged, it can cause platelets to adhere to the local thrombus, and then fibrin deposition causes the thrombus to increase, leading to occlusion of the lumen. Even spread to nearby or distant veins.

an examination

Related inspection

Angiography

According to the different sites of thrombosis, it can be divided into two categories.

Superficial vein thrombosis

Often involving the great saphenous vein or small saphenous vein or its branches, mostly on the basis of varicose veins. The main feature is the pain in the thrombus formation. The superficial vein has a red, low-heat cord, tenderness, and redness around it. The embolus is not easy to fall off and generally does not cause pulmonary embolism. In addition, migratory superficial vein thrombosis is often a suggestive symptom of cancer.

2. Deep vein thrombosis

According to its location and condition, it can be divided into the following two types.

(1) deep vein thrombosis of the calf: often occurs in the deep veins of the calf, such as the posterior tibial vein and the iliac vein. More common in patients who are less active in bed, often occurs in the second week after surgery. The left lower extremity is the most common. It is characterized by pain and tenderness in the muscles of the calf and ankle. It is severely painful after exercise, and the dorsiflexion of the foot is even worse, and the systemic symptoms are not significant. There may be Homan's sign at the time of examination, that is, the calf is straight, the foot is dorsiflexed, and the vein of the gastrocnemius is pulled by the vein and pain occurs. It can also appear that the circumference of the gastrocnemius muscle is thicker than the healthy side by more than 5 cm.

(2) sputum, femoral vein thrombosis: can be secondary to the calf vein thrombosis, but more than the primary iliac vein. Common in postpartum, rapid onset, severe diffuse edema of the affected limb, elevated skin temperature or slight spasm, superficial vein dilatation, unbearable pain in the inner thigh and significant tenderness along the vein, especially in the trigone. The systemic symptoms are not heavy.

Deep vein thrombosis is due to invasion of the main vein, and can produce peri-venous inflammation, affecting adjacent lymphatic vessels or causing arterial spasm, so the symptoms and signs are heavier. In addition, serious complications can occur, and when the thrombus is extended to the inferior vena cava, it can cause pulmonary embolism, and sometimes it can be the first symptom of the disease. Can be secondary to pulmonary hypertension.

Differential diagnosis

A differential diagnosis of a red, low-heat cord in the superficial vein:

1, a red line, swimming shallow veins: migratory thrombophlebitis: the superficial veins of the affected limbs are red, and can resolve after a few weeks. After a period of time, it can appear in different or the same part, accompanied by pain and tenderness. It is one of the clinical manifestations of thrombotic vasculitis.

2, local venous chord-like: along the superficial veins appear a strip or induration, accompanied by redness, burning, pain or tenderness, after the acute phase, the cord is hardened, local skin pigmentation, the above symptoms are seen in Thrombotic superficial phlebitis.

According to the different sites of thrombosis, it can be divided into two categories.

1. Superficial vein thrombosis: often involving the great saphenous vein or small saphenous vein or its branches, mostly on the basis of varicose veins. The main feature is the pain in the thrombus formation. The superficial vein has a red, low-heat cord, tenderness, and redness around it. The embolus is not easy to fall off and generally does not cause pulmonary embolism. In addition, migratory superficial vein thrombosis is often a suggestive symptom of cancer.

2. Deep vein thrombosis: According to its location and condition, it can be divided into the following two types.

(1) deep vein thrombosis of the calf: often occurs in the deep veins of the calf, such as the posterior tibial vein and the iliac vein. More common in patients who are less active in bed, often occurs in the second week after surgery. The left lower extremity is the most common. It is characterized by pain and tenderness in the muscles of the calf and ankle. It is severely painful after exercise, and the dorsiflexion of the foot is even worse, and the systemic symptoms are not significant. There may be Homan's sign at the time of examination, that is, the calf is straight, the foot is dorsiflexed, and the vein of the gastrocnemius is pulled by the vein and pain occurs. It can also appear that the circumference of the gastrocnemius muscle is thicker than the healthy side by more than 5 cm.

(2) sputum, femoral vein thrombosis: can be secondary to the calf vein thrombosis, but more than the primary iliac vein. Common in postpartum, rapid onset, severe diffuse edema of the affected limb, elevated skin temperature or slight spasm, superficial vein dilatation, unbearable pain in the inner thigh and significant tenderness along the vein, especially in the trigone. The systemic symptoms are not heavy.

Deep vein thrombosis is due to invasion of the main vein, and can produce peri-venous inflammation, affecting adjacent lymphatic vessels or causing arterial spasm, so the symptoms and signs are heavier. In addition, serious complications can occur, and when the thrombus is extended to the inferior vena cava, it can cause pulmonary embolism, and sometimes it can be the first symptom of the disease. Can be secondary to pulmonary hypertension.

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