Chemical phlebothrombosis of large veins. A not uncommon complication of total parenteral nutrition.

Thrombosis of large veins during total parenteral nutrition (TPN) is considered uncommon. Recently, clinical and phlebographic evidence of large-vein thrombosis were encountered in five patients among 200 consecutive patients receiving TPN. The symptoms, signs, and phlebographic findings occurred within one to two days, sometimes as early as a few hours after cannulation. It is suggested that thrombosis of large veins during TPN is not uncommon and is the result of chemical phlebothrombosis due to a hypersensitivity reaction of the venous wall to the polyvinyl catheter material. Early removal of the offending catheter is advocated.