Phlegmasia cerulea dolens: Difference between revisions

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'''Phlegmasia cerulea dolens''' is an uncommon but severe form of [[deep venous thrombosis]] which results from extensive thrombotic occlusion of the major extremity veins and their collateral. It is characterized by sudden severe pain, swelling, [[cyanosis]] and [[edema]] of the affected limb. There is a high risk of massive [[pulmonary embolism]], even under [[anticoagulation]]. Foot [[gangrene]] may occur and is often followed by followed by circulatory collapse and shock. Delay in treatment can be fatal or can lead to loss of limb.
{{CMG}}; {{AE}} {{USAMA}}
 
'''Phlegmasia cerulea dolens''' is a rare but severe form of [[deep venous thrombosis]] which results from extensive thrombotic occlusion of the major extremity veins and their collaterals. It is characterized by sudden severe pain, swelling, [[cyanosis]] and [[edema]] of the affected limb. [[Cyanosis]] is pathognomic for Phlegmasia cerulea dolens. There is a high risk of massive [[pulmonary embolism]], even under [[anticoagulation]]. Foot [[gangrene]] may occur and is often followed by circulatory collapse and shock. Delay in treatment can be fatal or can lead to loss of limb.


==Treatment options==
==Treatment options==
*Phlegmasia cerulea dolens is the only indication of thrombolysis or thrombectomy in patients with [[deep vein thrombosis]].
*Initiation of [[heparin]] followed by assessment for further management with thrombolysis or thrombectomy is done based on clinical presentation.
*Use of IVC filter is based on physician preference and a consensus does not yet exist on its use.
*See [[Deep vein thrombosis]]
*See [[Deep vein thrombosis]]



Revision as of 14:41, 12 November 2019

Phlegmasia cerulea dolens
DiseasesDB 32484
MedlinePlus 000200

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Phlegmasia cerulea dolens is a rare but severe form of deep venous thrombosis which results from extensive thrombotic occlusion of the major extremity veins and their collaterals. It is characterized by sudden severe pain, swelling, cyanosis and edema of the affected limb. Cyanosis is pathognomic for Phlegmasia cerulea dolens. There is a high risk of massive pulmonary embolism, even under anticoagulation. Foot gangrene may occur and is often followed by circulatory collapse and shock. Delay in treatment can be fatal or can lead to loss of limb.

Treatment options

  • Phlegmasia cerulea dolens is the only indication of thrombolysis or thrombectomy in patients with deep vein thrombosis.
  • Initiation of heparin followed by assessment for further management with thrombolysis or thrombectomy is done based on clinical presentation.
  • Use of IVC filter is based on physician preference and a consensus does not yet exist on its use.
  • See Deep vein thrombosis

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References

  • Barham, Kalleen (2007 Jan 18). "Images in Clinical Medicine: Phlegmasia Cerulea Dolens". The New England Journal of Medicine. 356 (3): e3. PMID 17229945. Unknown parameter |coauthors= ignored (help); Check date values in: |date= (help)