Superficial thrombophlebitis of the lower extremity

Superficial thrombophlebitis in the lower extremity is seen most frequently in middle-aged and elderly patients with longstanding varicose veins. It may result from minor trauma to the extremity, but it develops most frequently because of venous stasis in the large, dilated, tortuous phlebosclerotic veins that usually are tributaries of the long saphenous vein.
The condition usually commences in the veins of the medial aspect of the upper part of the lower leg. It is characterized by tenderness over the involved veins, which are firm to hard on palpation.
The skin overlying the involved veins becomes red, suggesting that there is underlying in­fection, but the condition is rarely septic.
The thrombotic process may extend into the main saphenous trunk, then extend proximally in the common femoral vein if untreated. If seen early, the process may sometimes be limited to the tortuous varices by the use of elastic Ace bandages with a pad of cellucotton beneath for additional pressure over the involved veins. It is also important to keep the patient ambulatory instead of putting him at bed rest.
If the process has extended up to the groin as shown, or even if it has extended only into the lower thigh, the patient should be treated surgically because of the danger that it may extend into the deep venous system, thereby resulting in pulmonary embolism.

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