[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Blood vessels](https://durgical.com/en/general-pathology/areas/vessels/) › Thrombophlebitis and vena cava syndromes # Thrombophlebitis and vena cava syndromes - Lesion Clots in veins, with or without inflammation, most often in the deep veins of the legs. Tumours can also squeeze or clog the great veins. Updated Nov 12, 2026 ## Key points - Deep vein thrombosis is often silent; the main danger is pulmonary embolism. - Risk factors: immobilisation, surgery and trauma, heart failure, pregnancy and the postpartum period, estrogen, cancer, inherited thrombophilia. - Trousseau syndrome: migratory superficial thrombophlebitis with mucin-producing carcinomas (pancreas, lung, stomach). - Superior vena cava syndrome: lung cancer (especially small cell) and lymphoma; facial and arm swelling, dilated neck and chest veins, dyspnea. - Inferior vena cava syndrome: renal cell and hepatocellular carcinomas growing into the IVC, or thrombosis; leg edema and abdominal wall veins. ## What it is Thrombophlebitis (thrombosis with inflammation) and phlebothrombosis (thrombosis without much inflammation) describe the same process. Deep leg veins account for most cases, driven by Virchow's triad: stasis (immobility, heart failure), endothelial injury and hypercoagulability (cancer, pregnancy, estrogen, inherited thrombophilia). Migratory thrombophlebitis (Trousseau sign) is a paraneoplastic hypercoagulable state. Superior vena cava syndrome is usually caused by tumours in the mediastinum; inferior vena cava syndrome by tumours invading or compressing the IVC or by thrombosis. ## Structure - Venous thrombus: soft, red, cast-like; lines of Zahn are less obvious than in arterial thrombi; attached at its point of origin. - Thrombophlebitis: inflammatory cells in the vein wall around the thrombus. ## Step by step - Stasis, endothelial injury or hypercoagulability tilt hemostasis toward clotting in a vein. - A red thrombus (rich in red cells and fibrin) forms, often behind a valve cusp. - It propagates toward the heart; inflammation of the wall may make it painful. - Fragments can break off and embolise to the lungs. - Unresolved thrombi organise and destroy valves, leading to post-thrombotic syndrome. ## Clinical notes - Leg swelling, pain and warmth suggest deep vein thrombosis, but signs are unreliable; ultrasound confirms. - Unexplained recurrent or migratory venous thrombosis in an older adult should prompt a search for cancer. ## Memory aid Stasis, damage, sticky blood: clots in the leg travel to the lung; a tumour can clot the veins from afar (Trousseau) or block the big ones up close (cava syndromes). ## Test yourself Think of the answer, then tap the question to see it. ## What is Trousseau syndrome? Migratory superficial thrombophlebitis caused by a cancer-associated hypercoagulable state, typically with pancreatic or other mucin-secreting adenocarcinomas. ## Which tumours most often cause superior vena cava syndrome? Lung carcinoma (especially small cell) and mediastinal lymphomas. ## What is the most feared complication of deep vein thrombosis? Pulmonary embolism. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/thrombophlebitis-and-vena-cava-syndromes/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Elsewhere in DurgiPedia - [Signs of deep vein thrombosis: Homans and the Wells score](https://durgical.com/en/clinical-exam/signs-of-deep-vein-thrombosis-homans-and-the-wells-score/) ## Connections ## Related 6 - [Thrombosis and Virchow's triad](https://durgical.com/en/general-pathology/thrombosis-and-virchow-s-triad/) - [Pulmonary thromboembolism: where it comes from and what it does](https://durgical.com/en/general-pathology/pulmonary-thromboembolism-where-it-comes-from-and-what-it-does/) - [Paraneoplastic syndromes: the table to know](https://durgical.com/en/general-pathology/paraneoplastic-syndromes-the-table-to-know/) - [Hypercoagulable states: inherited and acquired](https://durgical.com/en/general-pathology/hypercoagulable-states-inherited-and-acquired/) - [Varicose veins and venous insufficiency](https://durgical.com/en/general-pathology/varicose-veins-and-venous-insufficiency/) - [Lung carcinoma: spread and paraneoplastic syndromes](https://durgical.com/en/general-pathology/lung-carcinoma-spread-and-paraneoplastic-syndromes/) ## Related conditions 6 - [Deep vein thrombosis](https://durgical.com/en/conditions/deep-vein-thrombosis/) - [Superficial thrombophlebitis (superficial vein thrombosis)](https://durgical.com/en/conditions/superficial-thrombophlebitis/) - [Superior vena cava syndrome](https://durgical.com/en/conditions/superior-vena-cava-syndrome/) - [Lung cancer](https://durgical.com/en/conditions/lung-cancer/) - [Pulmonary embolism](https://durgical.com/en/conditions/pulmonary-embolism/) - [Pancreatic cancer](https://durgical.com/en/conditions/pancreatic-cancer/) [← All of general pathology](https://durgical.com/en/general-pathology/) Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given. Sources: [Thrombophlebitis: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/001108.htm) (MedlinePlus, US National Library of Medicine, 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/thrombophlebitis-and-vena-cava-syndromes/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/thrombophlebitis-and-vena-cava-syndromes/