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Revista Médica Sinergia

2022, Number 06

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Revista Médica Sinergia 2022; 7 (06)

Phlegmasia cerulea dolens: a forgotten presentation of deep venous thrombosis

Araya ZA, Morelli MI, Gamboa MS

Language: Spanish
References: 15
Page:
PDF size: 221.58 Kb.


ABSTRACT

Phlegmasia cerulea dolens is a rare but life-threatening complication of deep vein thrombosis. This occurs more frequently between the ages of 40 and 60, and in women and people with conditions that lead to a state of hypercoagulability, stasis, and impaired blood flow. It is characterized by the sudden appearance of edema, pain and cyanosis in the affected extremity, and it is more common in the left lower limb due to the compression exerted by the common iliac artery on the iliac vein. With regard to its pathophysiology, it is mainly attributed to an increase in interstitial pressure and hypovolemia that leads to compromised arterial perfusion and later necrosis and gangrene. Its suspicion is mainly clinical, and the presence of a venous thrombotic process can be confirmed by Doppler US. However, the gold standard for its diagnosis continues to be catheter-guided venography. There is no single established treatment for phlegmasia cerulea dolens, but there is consensus that its approach must be rapid and multidisciplinary due to the high risk of amputations and associated mortality. Existing treatments include invasive methods such as surgery and percutaneous interventions, and non-invasive ones through anticoagulation and fibrinolysis.


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