Phlegmasia cerulea dolens definition of phlegmasia cerulea. Pronunciation of phlegmasia cerulea dolens with 1 audio pronunciation, 1 meaning, 2 translations and more for phlegmasia cerulea dolens. Alternative names deep vein thrombosis phlegmasia cerulea dolens. In the lower extremities, leftside involvement is three to four times more common. Deep venous thrombosis uncomplicated phlegmasia alba dolens. Phlegmasia cerulea dolens with compartment syndrome ncbi.
Phlegmasia cerulea dolens pcd is an uncommon but potentially life threatening. Phlegmasia cerulea dolens is one of the infrequent but most severe forms of venous thrombotic disease. Pcd is the term used to describe lowerextremity dvt that causes limb ischemia, and is characterized by severe swelling and blue discoloration of the extremity. Flegmasia cerulea dolens pdf phlegmasia cerulea dolens literally. Phlegmasia alba dolens also colloquially known as milk leg or white leg is part of a spectrum of diseases related to deep vein thrombosis. Phlegmasia cerulea dolens is an uncommon, severe form of deep venous thrombosis blood clots in the vein.
The diagnosis and the efficient treatment are vital to prevent gangrene. Pointofcare ultrasound pocus can expedite the diagnosis, leading to earlier life and limbsaving treatment. The imported definitions may be significantly out of date, and any more recent senses may be completely missing. This occurs when the leg is swollen and white due to a clot in a deep vein that blocks blood flow. San francisco, california f we clinical entity phlegmasia cerulea dolens was first described in the french literature by tremolieres and veran in 1929. May 11, 2020 phlegmasia cerulea dolens pcd is a rare entity that is associated with significant morbidity and mortality, including limb ischemia and pulmonary embolism.
Phlegmasia cerulea dolens a limb threatening problem current. Pdf phlegmasia cerulea dolens with compartment syndrome. Pdf trends in management of phlegmasia cerulea dolens. The phlegmasia cerulla dolens is isquemic venous thrombosis in a reversible state of unknown cause and is a consequence of acute venous obstruction of a venous vascular trunk.
Only 40% of ambulatory ed patients with pe have concomitant dvt. It is therefore logical to deliver the lytic agent to the capillary bed by the arterial route. A complication of filter use in the inferior vena cava, successfully treated with ultrasoundassisted, catheterdirected thrombolysis september 5, 2016 bookmark this page. There is a high risk of massive pulmonary embolism. Phelgmasia cerulea dolens diagnosed by pointofcare ultrasound. Phlegmasia cerulea dolens in a patient with breast cancer and. Phlegmasia cerulea dolens penn state hershey medical center. Historically, it was commonly seen during pregnancy and in mothers. Pad is known by the triad of edema, pain, and blanching alba without cyanosis. Phlegmasia cerulea dolens pcd is a rare form of massive venous thrombosis of the lower extremities associated with a high degree of morbidity including venous gangrene, compartment syndrome, and. Historically, it was commonly seen during pregnancy and in mothers who have just given birth. Phlegmasia cerulea dolens pcd is a fulminant condition of acute massive venous thrombosis that may result in major amputation or death unless treated in an early phase. Phlegmasia cerulea dolens in a patient with breast.
Phlegmasia cerulea dolens a rare, lifethreatening condition article pdf available in the scientific world journal 9. Pdf phlegmasia cerulea dolens pcd is a fulminant condition of acute massive venous thrombosis that may result in major amputation or. Phlegmasia cerulea dolens is an uncommon manifestation of deep venous thrombosis that results from total or neartotal occlusion of venous outflow from the limb. In phlegmasia alba dolens, the thrombosis involves only major deep venous channels of the extremity, therefore sparing collateral veins. Phlegmasia definition of phlegmasia by the free dictionary. We present a case of a dialysisdependent endstage renal disease patient who originally presented with sepsis and later developed. Aug, 2018 phlegmasia cerulea dolens pcd is more advanced and considered a precursor of frank venous gangrene.
Internal jugular and subclavian vein thrombosis in a case of ovarian cancer donati, cancer and thrombosis. Phlegmasia cerulea dolens a rare, lifethreatening condition. Phlegmasia cerulea dolens pcd is an uncommon but potentially lifethreatening. Images in clinical medicine from the new england journal of medicine phlegmasia cerulea dolens with compartment syndrome. A multimodal therapeutic approach to phlegmasia cerulea.
Phlegmasia alba dolens is part of a spectrum of diseases related to deep vein thrombosis. It is characterized by sudden severe pain, swelling, cyanosis and edema of the affected limb. Phlegmasia cerulea dolens definition phlegmasia cerulea dolens is an uncommon, severe form of deep venous thrombosis blood clots in the vein. Phlegmasia cerulea dolens information mount sinai new york. Phlegmasia cerulea dolens is a rare form of massive proximal e. Thrombosis involving only the major deep venous channels but sparing the collateral. Phlegmasia cerulea dolens and phlegmasia alba dolens can present as compartment syndrome. Phlegmasia cerulea dolens pcd is a rare form of massive venous thrombosis of the lower extremities associated with a high degree of morbidity including venous gangrene, compartment syndrome, and arterial compromise. Phlegmasia cerulea dolens phlegmasia erulea dolens pd erulea means lue referred to as painful lue leg rare condition that occurs in aug, 2018 phlegmasia alba dolens pad and phlegmasia cerulea dolens pcd predominantly affect the lower extremities, with fewer than 5% of cases believed to involve the upper extremities.
This form of phlebitis is known by a number of names, most of which are descriptive of its clinical findings. A case of phlegmasia cerulea dolens somasamudra p broomfield hospital, chelmsford, united kingdom. Phlegmasia cerulea dolens phlegmasia erulea dolens pd erulea means lue referred to as painful lue leg rare condition that occurs in jan 25, 2016. May 25, 2014 phlegmasia cerulea dolens pcd represents the most severe acute consequence of dvt. Jan 24, 2016 diagnosis and management of phlegmasia cerulea dolens in the emergency department. Phlegmasia cerulea dolens pcds is a rare and serious complication of massive deep venous thrombosis of the lower extremities, which has a high mortality rate. Phlegmasia cerulea dolens blue, painful leg is an uncommon manifestation of deepvein thrombosis and results from massive thrombosis compromising venous outflow, which causes ischemia. Patients usually present with edema, pain, blanching and it may progress to gangrene and systemic shock in severe cases. He received heparin and inferior vena cava ivc filter placement followed by anticoagulation therapy with warfarin. Phlegmasia cerulea dolens a limb threatening problem. Phlegmasia alba dolens definition of phlegmasia alba dolens.
Phlegmasia alba dolens, which translates to painful white inflammation, occurs when venous thrombosis progresses to a massive occlusion of the major deep venous system of the leg, but without ischemia as collateral veins are still patent. Phlegmasia cerulea dolens describes clot formation in the venous system over a large area. It also shows how rare pathologies can combine to create a life and limb threatening condition. Phlegmasia alba dolens literally means painful white edema. Symptoms severe pain, rapid swelling, and bluishskin coloring affect the area below the blocked vein. Phlegmasia cerulea dolens is preceded by a condition called phlegmasia alba dolens. Prompt diagnosis along with pharmacological and endovascular therapy is the key to avoiding complications such as gangrene 4060 %, amputation 2050 %, and death 2540 %. Phlegmasia cerulea dolens with compartment syndrome youtube. Prompt fasciotomies were performed, but the underlying massive venous thrombosis was not addressed surgically. Despite all of the therapeutic modalities described above, phlegmasia cerulea dolens and venous gangrene still remain lifethreatening and. Phlegmasia cerulea dolens pcd is a rare entity that is associated with significant morbidity and mortality, including limb ischemia. Differential diagnosis clinical spectrum of venous thromboembolism. Phlegmasia cerulea dolens refers to congestion and cyanosis of a limb due to massive venous thrombosis. Phlegmasia cerulea dolens radiology reference article.
Phlegmasia cerulea dolens medical definition merriam. Phlegmasia cerulea dolens is a rare but serious complication of deep venous thrombosis, which can lead to arterial. Deep venous thrombosis dvt affects mainly the veins in the lower leg and the thigh. It is characterized by the sudden onset of severe leg pain, massive edema, cyanosis. Phelgmasia cerulea dolens diagnosed by pointofcare. It was first described by hildanus in the 16 th century. Phlegmasia alba and cerulea dolens are rare diseases along a spectrum of deep venous thromboses. Phlegmasia cerulea dolens phlebitis blue of gregoire. It received the name milk leg because it was once thought to be caused by the metastasis of milk. It typically presents in an elderly population often with coexistent.
Pdf phlegmasia cerulea dolens in a long distance driver. Flegmasia cerulea dolens pdf april 4, 2020 phlegmasia cerulea dolens literally. In phlegmasia cerulea dolens the primary lesion is the thrombosis within the capillary bed leading to compartment syndrome and subsequent gangrene. Flegmasia cerulea dolens quando existe cianose, com grave comprometimento circulatorio 1 flegmasia alba dolens quando nao ha cianose, mas sim palidez devido a isquemia secundaria ao compromisso do fluxo arterial por cesse do retorno venoso. The swelling of the lower limb and coloring improved gradually, and he was discharged after an uneventful course.
Phlegmasia alba dolens definition of phlegmasia alba. Phlegmasia cerulea dolens pcd is a severe presentation of massive dvt, and it is often associated with extremity catheterdirected thrombolytic therapy in deep venous thrombosis of the lower extremity. A diagnosis of phlegmasia cerulea dolens pcd and pulmonary embolism pe was established. It also shows how rare pathologies can combine to create a life and limbthreatening condition. In cases of pregnancy, it is most often seen during the third trimester, resulting from a compression of the left common iliac vein against the pelvic rim by the. Phlegmasia cerulea dolens with compartment syndrome nejm. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. It compounds with pulmonary embolism pe and deep vein thrombosis dvt. Phlegmasia cerulea dolens pcd is an uncommon complication of deep venous thrombosis, which results from extensive thrombotic occlusion of the major and collateral veins of an extremity usually the legs. The left lower limb showed a phlegmasia cerulean dolens. An 85yearold woman with newly diagnosed metastatic nonsmallcell lung cancer was admitted for pain control. It is the more severe form of phlegmasia alba dolens pad, and can lead to venous gangrene. Combining open thrombectomy with endovascular tech niques not only.