Manifests as tender nodules with localised induration and erythema
Mostly GSV but can occur in SSV
DUS, follow-up with short-term repeat DUS, and anticoagulation if the SVT approaches deep veins
Traumatic thrombophlebitis
Often seen in IVDU or hospital patients
Pain, tenderness and erythema at the site
Anticoagulation depends on severity of symptoms and underlying hypercoagulable conditions
May take weeks to months to resolve
Septic and suppurative thrombophlebitis
Intense pain at IV site, fever, leucocytosis
Excision of the vein is rarely needed
Migratory thrombphlebitis
Repeated thrombosis developing in superficial veins at varying sites but most commonly in the lower extremity
May be associated with carcinoma (Trousseau syndrome) - evaluate for occult malignancy
Also seen in Behcet disease, Buerger disease and polyarteritis nodosa
Mondor disease
Thrombophlebitis of the thoracoepigastric vein of the breast and chest wall
Associated with breast cancer or hypercoagulable states
Name has also been applied to SVT of the dorsal vein of the penis, which can occur after hernia operations, and in association with excessive sexual intercourse. Treat with NSAIDs. Rarely needs excision of the vein.
Upper extremity superficial thrombophlebitis
Typically occurs after cannulation and infusion of caustic substances that damage the endothelium
Progression to DVT is less common than in the lower limb
Reduce the risk of SVT extension or recurrence by 67%
Small SVTs with obvious inciting factors such as IVC should be treated with 6/52 NSAIDs
Anticoagulation
Rutherford's suggests prophylactic LMWH for 45 days in patients with >5cm of SVT
UTD suggests anticoagulation for patients that remain symptomatic after basic steps have been taken, or if they are considered high-risk for DVT/PE progression
