Phlebitis migrans

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 02/04/2015

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163 Phlebitis migrans

Instruction

Look at this patient’s leg: he has had similar such lesions at different sites at intervals.

Salient features

History

• Time course, pain and tenderness of skin lesions

• Ask the patient about:

• local trauma (including intravenous infusions)
• gastrointestinal malignancies (pancreatic or gastric cancer)
• history of oral contraceptives.

Examination

• Inflamed superficial leg veins.

Proceed as follows:

Tell the examiner that you would like to investigate for the underlying malignancy, usually carcinoma of the pancreas or stomach (Trousseau’s sign; Fig. 142.1) (N Engl J Med 1992;327:1128–33, N Engl J Med 1994;327:1163–4).

Diagnosis

This patient has migratory phlebitis (lesion) and I would like to investigate for an underlying pancreatic or gastric malignancy (aetiology).

Advanced-level questions

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