• The postphlebitic syndrome in the lower extremity follows thrombosis in the deep veins of the pelvis, thigh, or leg; the symptoms are edema, development of collateral veins, pigmentation, induration, especially above the medial malleolus, a characteristic dermatitis, and ulcer. In about half the cases the thrombosis was connected with childbirth, injury, surgery, infectious disease, or prolonged immobilization. Recanalization of the thrombus destroys the valves and leads to postural regurgitation. Incometent communicating veins freely transmit, from the deep to the superficial veins, the sudden rises of venous pressure during coughing, lifting, straining, and sneezing. The symptoms follow in a definite sequence, and the patient may present himself at any stage, from that of the initial thrombosis and subsequent bouts of periphlebitis, through the stages of edema, varicosities, pigmentation, dermatitis, and induration, to that of ulcer. In order to prevent the long-lasting, recurrent disabilities seen in the later stages, intensive treatment of the earlier stages is necessary.
de Takats G. POSTPHLEBITIC SYNDROME. JAMA. 1957;164(17):1861-1867. doi:10.1001/jama.1957.02980170001001