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Surgical Intervention for Phlegmasia Cerulea Dolens in a 61-Year-Old Cancer Patient

Christopher Ruben-Castillo1, Cesar Cuen-Ojeda1, Gabriel Lopez-Peña1

  • 1Section of Vascular Surgery and Endovascular Therapy, Department of Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Texas Heart Institute Journal
|January 31, 2022
PubMed

Insights

Phlegmasia cerulea dolens, a severe deep vein thrombosis complication, can be limb-threatening. Prompt open surgical thrombectomy successfully treated a patient, restoring venous flow and saving her leg.

Area of Science:

  • Vascular Surgery
  • Cardiovascular Medicine

Background:

  • Phlegmasia cerulea dolens is a rare, severe complication of deep vein thrombosis (DVT).
  • It presents with significant edema, pain, and cyanosis, potentially leading to limb ischemia and death.

Observation:

  • A 61-year-old woman with breast cancer developed phlegmasia cerulea dolens in her left leg.
  • The patient exhibited classic signs and symptoms of this critical condition.

Findings:

  • Prompt treatment with open surgical thrombectomy and distal compression using an Esmarch bandage was performed.
  • This intervention successfully restored venous flow and prevented limb loss.

Implications:

  • Open surgical thrombectomy is a viable and effective treatment for limb-threatening phlegmasia cerulea dolens.
  • Early surgical intervention can be life- and limb-saving in acute DVT complications.

Keywords:
Acute diseasefemoral vein/surgerylimb salvagelower extremity/blood supplythrombectomy/methodstime factorstreatment outcomevenous thromboembolism/complicationsvenous thrombosis/surgery

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