Superficial Vein Thrombophlebitis of Lower Limb Caused by an Intra-vascular Foreign Metallic Body

Abstract

Superficial thrombophlebitis of the lower limb is a common, frequent pathology, which most of the time does not require anticoagulant treatment. However, the condition can evolve unfavorably, with the progression of the thrombus to the level of the deep venous system, causing deep vein thrombosis and pulmonary embolism. [1][2][3][4] We present the case of a 31-year-old male patient who presented to the emergency room for pain and inflammation in the lower right infragenicular limb, symptoms that appeared 6 days prior. Blood tests showed no significant modification. At the clinical infragenicular examination, an area of inflammation and induration was highlighted on the path of the great saphenous vein. The ultrasound examination revealed local thrombosis of the great saphenous vein as well as the presence of an intravenous body with a posterior acoustic shadowing of approximately 5 mm in diameter (Figure 1).According to the anamnesis, the patient had a minor accident a week earlier in which a metallic body flew and hit the patient at the level of the distal third of the medial face of the right thigh, with no signs of local bleeding, therefore he did not present to the hospital. Due to these findings, to better characterize the type and localization of the foreign body, a computed tomography angiography (CTA) of the lower limbs was performed. The radiological results of the CT were strongly indicative of the presence of a metallic body at the level of the great saphenous vein (Figure 2). Under local anesthesia, exploration of the thrombosed venous segment was performed, with ligation and extraction of the portion of the great saphenous vein that contained the foreign body (Figure 3). During follow-up, the patient was examined at 1 week, 1 month, 3 months, and 6 months after surgery. There were no signs of inflammation or local infection, and the surgical wound had healed.