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Clinical Signs Of Thrombosis and Treatment


Thrombi cause clinical manifestations either by obstructing arteries and veins and formation of emboli

Clinical Manifestations due to Venous Thrombi.

(1) superficial Venous Thrombi
     It occurs commonly in saphenous veins especially when there are varicosities.
     Clinical manifestations include;
  • Local congestion and swelling
  • Pain tenderness along the course of veins
  • Varicose ulcer
One thing which is peculiar to venous thrombi is that they don't embolize.

(2) Deep Venous Thrombi.
       They occur in deep veins of the leg. for example femoral, popliteal and iliac veins
       Clinical manifestations include;
  • Oedema of foot and ankle
  • Pain and tenderness on compression of calf muscles, This is also called "Homan's sign"
  • They may embolize and may cause pulmonary embolism and infarction.
(3) Thrombophlebitis and phlebothrombosis.
     Both terms refer to pain, tenderness, and oedema due to vascular stasis, oedema and distension of the affected vessel at the local site of thrombus formation. this usually follows the administration of cannula.

(4) Milk Leg
      It refers to painful white legs that occur in the third trimester of pregnancy

(5) Migratory Thrombophlebitis (Trousseau's Sign)
     It refers to appearance of thrombi in one vein that disappears and then re-appear in another vein. it occurs in visceral cancer especially some abdominal neoplasms.

Clinical Manifestations Due To Arterial Thrombosis.
Arterial thrombi develop in following conditions
  1. Atheroseclerosis
  2. Aortic aneurysms 
  3. Reumatic heart disease
  4. Myocardial infarction
Clinical conditions:
  1. Complete or partial obstruction of blood vessels and consequent infarction or ischemia of the organ supplied.
  2. Fragmentation of thrombi which embolize to the vessels of brain, kidney, spleen and legs with resultant infarction of these organs.
Treatment:

        Anticoagulants such as warfarin and haparin are commonly used to treat thrombosis. Warfarin is also used prophylactically to decrease the risk of post surgical thormbosis. (DVT etc). In case of Fresh thrombus streptokinase or alteplase are given.

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