aka Cardiovascular Curveball 002
What is the diagnosis?
- Phlegmasia Cerulea Dolens aka Phlegmasia coerulea dolens
- 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.
What are the complications?
Complications of Phlegmasia Cerulea Dolens
- Pulmonary embolism
- Venous Infarction of the limb
- Fluid sequestration in the limb and systemic inflammatory response syndrome leading to hypotension
How is this condition managed?
This a rare condition and the management is evolving.
- 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
LITFL Further Reading