This is a case report of a 47-year-old male with a history of hypertension and pre-diabetes who presented to the emergency department with dyspnea, progressive unilateral leg swelling and pain. The patient tested positive for coronavirus disease 2019 (COVID-19) infection about a week earlier. The patient was found to have an extensive clot burden of his lower extremity veins, both deep and superficial, which extended to his inferior vena cava (IVC). Based on the patient's clinical exam and ultrasound findings, the patient was diagnosed with impending phlegmasia cerulea dolens. Due to his renal failure, the patient was taken for a ventilation/perfusion (V/Q) scan which found widespread V/Q mismatch highly suggestive of pulmonary embolism. Interventional radiology took the patient for lower extremity venogram, catheter-directed alteplase administration, and IVC filter placement. The patient was admitted to the intensive care unit (ICU) for further management and had a stable recovery.
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| http://dx.doi.org/10.7759/cureus.17351 | DOI Listing |
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Hypercoagulability Due to COVID-19 Leading to Impending Phlegmasia Cerulea Dolens and Sub-Massive Bilateral Pulmonary Embolism.
Cureus
August 2021
Emergency Medicine, Graduate Medical Education, Aventura Hospital and Medical Center, Aventura, USA.
This is a case report of a 47-year-old male with a history of hypertension and pre-diabetes who presented to the emergency department with dyspnea, progressive unilateral leg swelling and pain. The patient tested positive for coronavirus disease 2019 (COVID-19) infection about a week earlier. The patient was found to have an extensive clot burden of his lower extremity veins, both deep and superficial, which extended to his inferior vena cava (IVC).
View Article and Find Full Text PDFSuccessful treatment of posttraumatic phlegmasia cerulea dolens by reconstructing the external iliac vein: a case report.
J Med Case Rep
May 2014
Division of Vascular and Thyroid Surgery, Department of Surgery, The First Affiliated Hospital, China Medical University, Shenyang 110001, China.
Introduction: Phlegmasia cerulea dolens is a rare condition caused by complete venous occlusion leading to impaired arterial flow. To prevent progression to limb gangrene, prompt diagnosis and treatment initiation are paramount. Here we report a rare case of posttraumatic phlegmasia cerulea dolens after ligation of the iliac vein to save the patient's life, with successful treatment by reconstructing the external iliac vein.
View Article and Find Full Text PDFSurgical venous thrombectomy for phlegmasia cerulea dolens and venous gangrene of the lower extremities.
J Med Assoc Thai
November 2013
Division of Vascular and Endovascular Surgery, Department of Surgery, Chiang Mai University Hospital, Chiang Mai, Thailand.
Objective: Phlegmasia cerulea dolens (PCD) and venous gangrene are limb and life-threatening conditions of iliofemoral acute deep vein thrombosis (DVT).
Material And Method: The authors retrospectively evaluated surgical management of 15 patients from 125 patients with acute iliofemoral DVT (6 PCD and 9 venous gangrene) between January 1991 and August 2002 with long-term follow-up.
Results: All of our 15 patients underwent surgery within 10 days of the onset of symptoms.
Endovascular treatment of phlegmasia cerulea dolens with impending venous gangrene: manual aspiration thrombectomy as the first-line thrombus removal method.
Cardiovasc Intervent Radiol
December 2011
Department of Radiology, Baskent University Faculty of Medicine, Adana Teaching and Medical Research Center, Dadaloglu Mahallesi, Yuregir, Adana 01250, Turkey.
Purpose: Our purpose was to report the outcome of endovascular treatment with manual aspiration thrombectomy as the first-line thromboablative method for phlegmasia cerulea dolens.
Methods: Between October 2006 and May 2010, seven consecutive patients (5 women, 2 men; age range, 31-80 years) with the diagnosis of phlegmasia cerulea dolens secondary to acute iliofemoral deep venous thrombosis had endovascular treatment with manual aspiration thrombectomy. Catheter-directed thrombolysis and stent placement were used as adjunctive procedures.
Successful treatment of phlegmasia cerulea dolens with combination surgical and catheter-assisted thrombectomy.
Vascular
July 2009
Department of Surgery, The University of Toledo Health Science Center, Toledo, OH 43614, USA.
Phlegmasia cerulea dolens is a rare condition caused by complete venous occlusion that leads to impaired arterial flow. Prompt diagnosis and treatment initiation are paramount in preventing progression to gangrene, the need for amputation, and possibly the death of the patient. Thrombolysis or surgical thrombectomy, for advanced disease and cases in which anticoagulation is contraindicated, represent the current standard treatment.
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