most Most serious complication of this condition

[IMG SURVIVOR]

A 55-year-old woman consults a physician because of edema involving her lower legs. While both of her ankles are swollen, the left one is much more swollen than the right. Physical examination additionally demonstrates a swollen, tender, bluish, cord-Iike structure immediately below the skin on her left lower leg extending from her ankle to near her knee. Edema at sites other than the ankles is not apparent on physical examination. The patient has not been having any other symptoms. The woman works as a nurse and had a long airplane trip during the previous week.


Which of the following is the most serious complication of this condition?
/ A. Focal arterial obstruction
/ B. Involvement of deep leg veins
/ C. Obstruction of a joint space
/ D. Rupture of an involved tendon
/ E. Secondary lymphangiosarcoma

[IMG SURVIVOR]

The correct answer is B. Superficial thrombophlebitis often resolves spontaneously without sequelae, but should always be taken very seriously because the same patients who develop superficial thrombophlebitis may either have an extension of the clot into the deep veins (with increased risk of potentially fatal pulmonary embolism) or may develop a separate deep venous clot concurrently or at a later date. In hospitalized patients with superficial thrombophlebitis, it is thought that as many as 10% eventually develop pulmonary embolus (typically from an undiagnosed or later deep vein thrombosis), and of this subset of patients with pulmonary embolus, 20% die.
The artery (choice A), joint space (choice C), and tendons (choice D) are not directly involved by this disease process.
Lymphangiosarcoma (choice E) is a rare complication of chronic lymphatic obstruction.