Phlegmasia cerulea dolens
Phlegmasia cerulea dolens is an uncommon severe form of deep venous thrombosis which results from extensive thrombotic occlusion of the major and the collateral veins of an extremity. It is characterized by sudden severe pain, swelling, cyanosis and edema of the affected limb. There is a high risk of massive pulmonary embolism, even under anticoagulation. Foot gangrene may also occur. An underlying malignancy is found in 50% of cases. Usually, it occurs in those afflicted by a life-threatening illness.
This phenomenon was discovered by Jonathan Towne, a vascular surgeon in Milwaukee, who was also the first to report the "white clot syndrome". Two of their HIT patients developed phlegmasia cerulea dolens that went on to become gangrenous.
Treatment is by catheter-directed thrombolytic therapy, a type of thrombolysis.Additional images
