Acute thrombosis of the lower limb deep veins remains one of the most common vascular diseases. It is characterised by formation of thrombotic masses in the system of the deep veins of the lower extremities. A serious complication associated with deep vein thrombosis is pulmonary embolism. In rare cases, under certain conditions a massive and disseminated blockade of the venous outflow with thrombotic masses may lead to ischaemia of the extremity with the formation of superficial and deep necroses and later on to gangrene. One of the main components of management is long-term administration of anticoagulants, which in a series of cases may result in the development of gastrointestinal haemorrhage which in its turn requires discontinuation of anticoagulants. Described herein is a clinical case report concerning treatment of a woman presenting with deep vein thrombosis and the development of phlegmasia cerulean dolens complicated by massive pulmonary artery thromboembolism on the background of intestinal bleeding.
Download full-text PDF |
Source |
---|
J Surg Case Rep
December 2024
Department of Vascular Surgery, Singapore General Hospital, Academia Level, Outram Rd, Singapore.
Phlegmasia cerulea dolens is a rare manifestation of massive deep vein thrombosis with threat to limb and life. A patient with a background of ovarian malignancy in remission and pelvic radiotherapy presented with left lower limb phlegmasia cerulea dolens as a result of extensive acute left lower limb deep vein thrombosis, extending from the popliteal vein to the inferior vena cava. While initial rapid thrombolysis and left iliac vein stenting were successful, she developed significant hemorrhagic complications from her right radial intra-arterial line with compartment syndrome requiring fasciotomy.
View Article and Find Full Text PDFJ Vasc Access
December 2024
Interventional Radiology Unit, Department of Medical Imaging, University Hospital of Heraklion, Heraklion, Greece.
Phlegmasia cerulea dolens (PCD) is a rare but limb-threatening complication of deep vein thrombosis. A 72-year-old hemodialysis male patient presented with upper limb PCD. The patient underwent hemodialysis via a permanent hemodialysis central venous catheter (HD-CVC) while a new brachial-cephalic AVF was created 1 month ago.
View Article and Find Full Text PDFCureus
June 2024
General Surgery, Trumbull Regional Medical Center, Warren, USA.
Venous duplications, particularly in the femoral vein, are rare anatomical variations that can complicate the clinical presentation and management of deep venous thrombosis (DVT). This case describes an elderly female who was diagnosed by her primary care physician with a left lower extremity DVT one week prior to her presentation and had been prescribed Xarelto. Despite strict adherence to therapy, her left leg pain, swelling, and discoloration worsened, prompting her hospital admission.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
October 2024
Corewell Health William Beaumont University Hospital, Royal Oak, MI.
A 57-year-old man presented after a fall, which resulted in acetabular and pelvic fractures. He underwent fracture fixation, which was complicated by iliac vein occlusion, leading to phlegmasia cerulea dolens. He underwent lower extremity surgical venous thrombectomy, contralateral iliac vein stent placement, and modified Palma procedure with an expanded polytetrafluoroethylene venous crossover bypass and arteriovenous fistula creation.
View Article and Find Full Text PDFClin Pract Cases Emerg Med
May 2024
Louisiana State University Health Sciences Center, Department of Emergency Medicine, New Orleans, Louisiana.
Introduction: Phlegmasia cerulea dolens (PCD) is an uncommon, potentially life-threatening complication of acute deep venous thromboses that requires a timely diagnosis. The name of the condition, the visual diagnostic criteria, and the preponderance of cases in the literature referencing findings exclusively in patients with lighter skin complexions means that PCD may not be on the differential diagnosis for the patient with more melanated skin who is experiencing this time-sensitive vascular emergency.
Case Report: We describe one case of PCD in a patient with darker skin complexion and the importance of identifying clinical findings, regardless of skin color, given the paucity of reference images for PCD in darker complected patients.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!