A 45-year-old woman with pre-existing great saphenous varicosities develops a painful, tender, red cord along the thigh varicosity. Duplex confirms superficial vein thrombosis of the great saphenous trunk extending to within 1 cm of the saphenofemoral junction, with no deep vein thrombus. What is the correct management?
- A Therapeutic-dose anticoagulation managed as a deep vein thrombosis ✓
- B Reassurance, compression stockings and analgesia only
- C Immediate high ligation and stripping under emergency conditions
- D Systemic antibiotics for seven days
Correct answer: A. Therapeutic-dose anticoagulation managed as a deep vein thrombosis
Explanation
Superficial vein thrombosis within 2 cm of the saphenofemoral junction carries a substantial risk of propagation into the deep system and embolism, so it is treated like a DVT with therapeutic anticoagulation. Simple conservative care is appropriate only for superficial thrombophlebitis well away from the junction, and antibiotics have no role unless there is bacterial cellulitis. Emergency surgery is not indicated when the deep system is patent.
Reference: Schwartz's Principles of Surgery, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.