Catastrophic presentation of venous thromboembolic disease

Abstract

Introduction

Phlegmasia cerulea dolens is a severe form of deep vein thrombosis of the lower limbs. It consists of the clinical triad of limb oedema, acute ischaemic pain and cyanosis, leading to venous congestion with oedema, massive fluid sequestration causing circulatory collapse and shock as the cause of death.

Case report

Female patient with deep vein thrombosis and development of phlegmasia cerulea dolens and pulmonary embolism.

Discussion

Phlegmasia cerulea dolens is a special form of deep vein thrombosis associated with proximal vein thrombosis, with signs of ischaemia. It should be suspected with the clinical symptoms of pain, oedema and cyanosis. Treatment includes: anticoagulation, thrombolysis and surgical thrombectomy; cases of acute haemodynamic ischaemias can require amputation of the limb.