A postoperative surgical patient develops pain, redness, and edema in the calf. These symptoms may potentially indicate which of the following conditions?
  1. Arterial embolism
  2. Varicose veins
  3. Thrombophlebitis
  4. Lymphedema
Explanation
Answer- C - Pain, redness, and edema in the calf of a postoperative patient indicates thrombophlebitis, resulting from venous stasis. Venous thrombosis (thrombophlebitis) refers to inflammation of a vein precipitating thrombus (blood clot) formation; it almost always occurs in the neck veins or occasionally in the trunk.
Types of venous thrombosis include:
a) Deep Vein Thrombosis (DVT), a stationary clot that forms in the deeper veins of the legs;
b) Superficial thrombophelbitis, an inflammation of a more superficial vein closer to the surface; this condition is accompanied by formation of a stationary clot within the vein. Phlebothrombosis refers to thrombus formation without venous inflammation. Phlebitis refers to inflammation of one or more veins without resultant clot formation. Thrombi formation is believed to occur when both venous stasis and hypercoagulability exist. Stagnated blood will accumulate in the pocket areas of the vessel valves, resulting in hypercoagulability (because activated coagulation factors are not removed from the blood).
Traces of thrombin activate the clotting mechanisms of platelet aggregation and conversion of fibrinogen to fibrin. Trauma or damage to the vessel walls from an injury or phlebitis may cause platelet adhesion to the vein wall. DVT and phlebitis are acute diseases that may result in pulmonary embolism (as pieces of the clot break off and travel to the lung) or chronic venous insufficiency.
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