Phlegmasia Cerulea Dolens: A Rare Case Report
Alireza Abootalebi1, Mohsen Salemi1, Farhad Heidari1
1Department of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Advanced Biomedical Research
|October 19, 2020
Summary
Phlegmasia cerulea dolens, a severe deep venous thrombosis (DVT), can lead to limb swelling and pain. Prompt anticoagulation is crucial for managing this critical condition.
Area of Science:
- Vascular Medicine
- Oncology
- Critical Care Medicine
Background:
- Phlegmasia cerulea dolens (PCD) is a rare, severe form of deep venous thrombosis (DVT).
- It presents with significant venous obstruction, causing limb swelling, pain, and potential gangrene.
- Risk factors include malignancy and recent chemotherapy, as seen in this case.
Observation:
- A 75-year-old woman with metastatic ovarian cancer and recent chemotherapy presented with abdominal pain and left leg swelling.
- She had a history of multiple comorbidities including diabetes, heart disease, and previous DVT.
- Clinical signs included coldness and swelling of the left leg, indicative of severe venous compromise.
Findings:
- Color Doppler sonography confirmed acute deep venous thrombosis (DVT) in the common femoral vein extending to the left external iliac vein.
- The patient received immediate anticoagulation with intravenous heparin and fluid resuscitation.
- Despite treatment initiation, the patient's condition was critical due to extensive DVT.
Implications:
- This case highlights the severe presentation of PCD in a patient with multiple comorbidities and recent chemotherapy.
- Early recognition and prompt anticoagulation are vital for managing PCD, although outcomes can be poor.
- Further research into optimizing DVT management in complex cancer patients is warranted.
