Superficial Thrombophlebitis

Question 1

What are three types of ST?

Answer 1

Sterile thrombophlebitis

Infective/traumatic thrombophlebitis

• May occur after prolonged cannulation or trauma to overlying skin.
• Infection or irritant e.g. sclerotherapy

Migratory thrombophlebitis
- Rarer - associated with malignancy (pancreatic cancer), polyarteritis nodosum

(Ref: GP Update UK Handout)

Question 2

What is the approach to management?

Answer 2

If <3cm from the SFJ –> anticoagulation
if >3cm but 5cm in length –> anticoagulation
If <2cm in length and away from the SFJ –> can treat symptomatically with NSAIDs

Anticoagulation according to ETG:
> low-dose LMWH (eg dalteparin 5000 units SC daily or enoxaparin 40 mg SC daily) OR
> unfractionated heparin (10 000 units SC twice daily) for 4 weeks