Abdominal wall thrombophlebitis

　　First, etiology

　　The etiology is unknown. There is often a history of trauma before the onset, and it is believed to be related to breast surgery, incision of abscess, and local compression; or it is caused by infectious变态 reactions such as tuberculosis, colds, and hepatitis.

　　Second, pathogenesis

　　Literature reports that in the early cases, the pathological specimens show reactive changes in the vessel wall, with lymphoid substances in the central lumen of the tendons, without red blood cell components, and lacking muscle fibers and elastic fibers, so it is considered to be a mild lymphatic inflammation. Zhang et al. in China found degenerated red blood cells and fresh thrombi in the lumen of acute cases, so it is believed that the disease is caused by venous thrombosis leading to venous vascular intimal lesions. The course of the disease varies from 15 days to 15 months.

　　1. Extensive venous thrombosis:If there is a possibility of the formation of thrombus in the lower leg veins to extend upwards to the femoral, iliac, and even the inferior vena cava;

　　2. Thromboembolism:Pulmonary embolism can occur within a few hours or days after thrombosis;

　　3. Chronic venous insufficiency after phlebitis:When the venous valves are severely damaged and the collateral circulation has not been fully established, serious conditions are likely to occur, starting with lower leg edema, followed by varicose veins, skin pigmentation, and finally, stasis dermatitis, stasis subcutaneous sclerosis, and stasis ulcers.

　　1. In the early stage of superficial tendons, there is often a shallow small cord on the chest and abdominal wall. Later, it gradually extends, the upper abdominal wall can extend to the chest wall to the axilla; the lower abdominal wall extends to the inguinal region.

　　2. Pain: When tendons are found, patients often have spontaneous pain or pulling pain during activity, which becomes the reason for patients to seek medical attention. Long-standing cases may also have no自觉 symptoms.

　　3. Subcutaneous superficial tendons are visible on the chest and abdominal wall, with a hard texture, no local redness or swelling. When one end of the tendons is pulled tightly with fingers, a concave skin shallow groove can appear on the skin. If both ends are pulled tightly, a cord-like bulge can appear on the skin, with varying degrees of tenderness in the local area.

　　Most patients seek medical attention due to the discovery of superficial tendons on the chest and abdominal wall, accompanied by spontaneous pain or pain when moving, with more spontaneous pain in patients with a short course of the disease.

　　Abdominal wall thrombophlebitis has self-limiting properties and can disappear spontaneously within 2 to 3 months, with a rare recurrence. For those who have been lying in bed for a long time, deep breathing and coughing exercises should be done to promote blood circulation; if intravenous infusion is required, it is best to avoid using irritant liquids. After surgery, encourage patients to do deep breathing exercises and lower limb exercises, especially foot stretching, as soon as possible to get out of bed and start moving.

　　1. Examination for abdominal wall thrombophlebitis:

　　If there are symptoms or signs mentioned above, accompanied by history of trauma or surgery, it can be highly suspected that this disease is present. Combined with the changes shown by superficial venous ultrasound, such as incompressible hyperechoic or anechoic tubular structures in the subcutaneous fat of the lesion area, it can be diagnosed in most cases. It needs to be differentiated from chest and abdominal wall muscle strain, epidemic myalgia, intercostal neuralgia, and other conditions.

　　2. The histopathology is nonspecific thrombophlebitis.

　　One, therapeutic diet for abdominal wall thrombophlebitis

　　1. Almond:Bitter almonds have a bitter and sweet taste, are neutral and moist, and enter the liver, heart, and large intestine meridians, with the effect of breaking blood stasis, moistening the intestines, and defecating. They can promote blood circulation, disperse blood stasis. Method of consumption: peel and remove the tip of the almond, soak it in wine for a week, dry it into powder, mix it with honey to make pills the size of a wutong seed, take twice a day, 15 pills each time, with yellow wine or boiled water.

　　2. Longan:Longan has a sweet taste and is neutral, non-toxic, and enters the spleen and heart meridians, with the effect of appetizing and benefiting the spleen. Longan meat can invigorate the body, calm the mind, and nourish the blood, making it a good fruit for nourishing the heart and blood. It can be used to treat symptoms such as physical weakness, deficiency of Qi and blood, postpartum blood deficiency, and decline of mental power. It is suitable for patients with all types of thrombophlebitis. Method of consumption: ① 9 grams of longan meat, 15 grams of red hull of peanuts, decocted in water. ② 5 pieces of longan meat, 15 grams of lotus seeds, and 30 grams of glutinous rice, cooked into porridge and eaten twice a day, in the morning and evening.

　　Two, what is good for the body to eat during abdominal wall thrombophlebitis?

　　1. Patients with heat-toxin injury should pay attention to their diet, which should include cooling and detoxifying foods that are easy to digest, such as mung beans, red beans, tea, pears, watermelons, and horse radish. They can drink chrysanthemum tea, honeysuckle dew, or use lotus leaves, bamboo leaves, and fresh plantain decoction as water.

　　2. Patients with deficiency of both Qi and blood are usually thin and lack strength, with muscle atrophy in the affected limb, dry and scaly skin, and chronic wounds. These people should pay attention to their diet, which should be rich in nutrition and easy to digest, such as lean meat, eggs, and milk. Astragalus, Codonopsis, Atractylodes, and jujube can be used to stew beef for consumption.

　　3. Patients with blood stasis and blockage can eat ginger, lamb soup, duck, deer blood, shanxi, cinnamon, and longan meat.

　　4. It is recommended to consume fresh vegetables, such as spinach, rapeseed, carrots, and cabbage, which are rich in vitamin C. Lean meat is unlimited, and it is suggested to take a bag of fresh milk or a banana before going to bed every day.

　　Three, what foods should be avoided for abdominal wall thrombophlebitis?

　　1. During the acute infectious period, it is best to avoid spicy foods, seafood, tobacco, and alcohol, which are irritant.

　　2. It is advisable to avoid foods with high calories such as lamb and dog meat during summer.

　　3. It is not advisable to eat fish, shrimp, crab, raw chicken, and other spicy foods.

　　4. Avoid smoking and drinking.

　　Prevention:

　　1. Promote the establishment of collateral circulation:For patients with chronic arterial insufficiency, insufficient collateral circulation directly affects tissue perfusion, ischemic pain in the affected limb limits the patient's activities, and is not conducive to the establishment of collateral circulation. The muscles in the affected limb will atrophy due to insufficient blood supply and disuse. Planned and progressive exercise can increase activity and promote the establishment of collateral circulation and increase perfusion of the peripheral tissues. Walking and Buerger exercises are commonly used.

　　2. Quit smoking and drinking and maintain a good attitude:Nicotine, alcohol, and emotional fluctuations can all excite the sympathetic nervous system, causing vascular spasm, and patients should be helped to quit smoking and drinking, and to consume less or no caffeine-containing beverages in the diet. Patients with trauma should eat less or no刺激性食物. Patients with arteriosclerotic diseases or diabetes should adhere to low-fat and low-sugar diets.

　　3. Avoid pressing on the affected limb:Tight clothing, sitting with legs crossed or legs crossed at the knees, and placing something under the crease of the hip to equalize, can compress the blood vessels and affect arterial blood supply, which should be avoided as much as possible.

　　4. Pay attention to warmth:Exposure to cold air and direct contact with cold objects, etc., can cause arterial constriction or spasm. It is necessary to maintain appropriate indoor temperature and humidity, avoid, and therefore it is necessary to promptly remove the necrotic tissue from the ulcer surface to promote the decomposition of necrotic tissue. After the wound is completely cleared, 'egg yolk oil medicine' and 'removing corruption and promoting muscle growth powder' can be selected according to the nature of the wound. For deep wounds, it is advisable to use soft gauze soaked in medicine to fill the wound, ensuring adequate drainage, so that granulation tissue can gradually grow from the bottom of the wound to fill it. For wounds with excessive exudates, various absorbent dressings such as hydrolyzed colloids and calcium alginate can be selected. In addition, in cases of unknown fever, pain, bleeding, suspected anaerobic bacterial infection, or when the dressing falls out, gets dirty, or there is an increase in pus and an unpleasant odor, it is necessary to change the dressing promptly. However, whether it is a fresh wound or an infected wound, do not apply antiseptic powder or colored drugs (such as gentian violet) to the wound during dressing changes to avoid affecting the observation of the wound. Dressing changes should not be too frequent, and care should be taken not to damage the newly formed granulation tissue when removing the dressing. At the same time, attention should be paid to whether there are allergic reactions to local medications.