Images in Clinical Medicine
Phlegmasia Cerulea Dolens
N Engl J Med 2007; 356:e3January 18, 2007
- Article
An 85-year-old woman with newly diagnosed metastatic non–small-cell lung cancer was admitted for pain control. Two days after admission, bluish discoloration of the left great toe was noted. Doppler ultrasonography revealed a left femoropopliteal deep-vein thrombosis. Anticoagulation with heparin was initiated, but there was progressive swelling and cyanosis of the leg (Panels A and B). The patient was referred for prophylactic placement of an inferior vena cava filter. Fluoroscopy revealed that the clot had extended into the left iliac vein and lower inferior vena cava. Filter placement was successful. However, despite continued intravenous anticoagulation and attempts at mechanical thrombectomy, the clinical findings progressed to venous gangrene. Phlegmasia cerulea dolens (blue, painful leg) is an uncommon manifestation of deep-vein thrombosis and results from massive thrombosis compromising venous outflow, which causes ischemia.
Kalleen Barham, M.D.
Tina Shah, M.D.
Albert Einstein Medical Center, Philadelphia, PA 19141
barhamk@einstein.edu - Citing Articles (2)
Citing Articles
1
Muffazal Lakdawala, Aparna Bhasker. (2010) Report: Asian Consensus Meeting on Metabolic Surgery. Recommendations for the use of Bariatric and Gastrointestinal Metabolic Surgery for Treatment of Obesity and Type II Diabetes Mellitus in the Asian Population. Obesity Surgery 20:7, 929-936
CrossRef2
Jiri Molacek, Vladislav Treska, Jan Baxa, Petr Duras, Vladimir Vesely. (2008) Phlegmasia cerulea dolens as a complication of a severe form of acute hemorrhagic-necrotizing pancreatitis. Blood Coagulation & Fibrinolysis 19:1, 98-100
CrossRef
