Gangrene of digits from phlegmasia cerulea dolens: A case report

Abstract

Phlegmasia cerulea dolens (PCD) is a rare and severe manifestation of deep vein thrombosis (DVT) characterized by extensive venous obstruction extending into collateral veins.¹ PCD’s relationship to compartment syndrome and gangrene is known but has not yet been thoroughly studied.² We present a case of PCD in a pre-menopausal woman, who developed compartment syndrome, post fasciotomy wound infection, and required subsequent multi-digit amputations due to dry gangrene. The patient presented initially to another hospital where they performed a right superficial femoral artery to anterior tibial bypass with reversed saphenous vein with right leg four compartment decompression fasciotomies. This case covers the severity of PCD and its ability to cause irreversible tissue damage even with timely intervention.

Level of Evidence: 4