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A multimodal therapeutic approach to phlegmasia cerulea dolens in a pediatric patient

Isabella Kuo1, Jason Smith, Ahmed M Abou-Zamzam

  • 1Division of Vascular Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA.

Journal of Vascular Surgery
|September 30, 2010
PubMed

Insights

Phlegmasia cerulea dolens, a severe deep venous thrombosis complication, was successfully treated in a pediatric patient. This case highlights effective multimodal interventions for limb salvage in children.

Area of Science:

  • Vascular Surgery
  • Pediatric Thrombosis
  • Critical Care Medicine

Background:

  • Phlegmasia cerulea dolens (PCD) is a rare, severe complication of deep venous thrombosis (DVT).
  • PCD typically affects elderly patients and can lead to limb ischemia and gangrene.
  • No prior cases of PCD have been reported in the ambulatory pediatric population.

Observation:

  • A 5-year-old girl presented with acute, extensive left lower extremity DVT.
  • The DVT progressed to phlegmasia cerulea dolens, causing significant limb compromise.
  • The patient's presentation was unusual given her age and ambulatory status.

Findings:

  • Pharmacologic and mechanical interventions, standard in adult PCD treatment, were applied.
  • The pediatric patient received aggressive, multimodal treatment.
  • Successful limb salvage was achieved through the applied interventions.

Implications:

  • This case demonstrates the feasibility of treating PCD in pediatric patients.
  • Aggressive, multimodal treatment strategies can be effective in pediatric PCD.
  • Successful limb salvage is achievable in pediatric cases of PCD, challenging previous assumptions.

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