phlegmasia cerulea dolens

Clinical manifestations

• proximal deep vein thrombosis of a limb, with sudden severe pain & swelling, cyanosis & edema,
• massive proximal DVTs involve both deep veins & collateral veins
• increased venous stasis, extravasation of venous fluid into the interstitium, painful swelling & violaceous changes
• arterial compromise (may result from compartment syndrome)

* images

Complications

• reperfusion injury
• acute renal failure
• compartment syndrome
• circulatory collapse & shock
• arterial ischemia & gangrene

Management

• unfractionated heparin for limb-threatening occlusive DVT
  • indicated for patients who may require thrombolytic therapy or emergent surgery
• fasciotomy for acute compartment syndrome
• catheter-directed thrombolysis

More general terms

• phlegmasia

Additional terms

• deep vein thrombosis (DVT)