Q1: What is the diagnosis?
Less frequent manifestations of venous thrombosis include phlegmasia alba dolens, phlegmasia cerulea dolens, and venous gangrene. These form a clinical spectrum of the same disorder.
All 3 manifestations result from acute massive venous thrombosis and obstruction of the venous drainage of an extremity. In phlegmasia alba dolens, the thrombosis involves only major deep venous channels of the extremity, therefore sparing collateral veins. The venous drainage is decreased but still present; the lack of venous congestion differentiates this entity from phlegmasia cerulea dolens.
Q2: What are the complications?
- Pulmonary embolism
- Venous Infarction of the limb
- Fluid sequestration in the limb and systemic inflammatory response syndrome leading to hypotension
Q3: How is this condition managed?
- Traditional treatment consists of standard anticoagulation
- However, increasingly, invasive therapies such as catheter directed thrombolysis, surgical thrombectomy and systemic thrombolysis are employed in these patients