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Tratamiento exitoso de la flegmasia cerúlea dolens mediante trombectomía quirúrgica: un informe de caso
Tomofumi Fukuda1, Kosuke Saku1, Koki Nakamura1
1Cardiovascular Surgery, St. Mary's Hospital, Kurume, JPN.
Cureus
|February 10, 2026
Resumen
La flegmasia cerulea dolens (PCD), una severa trombosis venosa profunda, puede imitar la oclusión arterial. La TC mejorada por contraste diagnosticó efectivamente la PCD en un paciente anciano, lo que permitió un tratamiento quirúrgico y anticoagulante exitoso.
Área de la Ciencia:
- Cirugía vascular Cirugía vascular.
- Radiología Radiología.
- Medicina de emergencia Medicina de emergencia.
Sus antecedentes:
- La flegmasia cerulea dolens (PCD) es una complicación rara pero potencialmente mortal de la trombosis venosa profunda (TVP).
- La DPC presenta signos clínicos que pueden confundirse con una oclusión arterial aguda, lo que requiere métodos diagnósticos precisos.
- El diagnóstico oportuno y correcto es crucial para el manejo eficaz del paciente y el rescate de extremidades.
Objetivo del estudio:
- Para resaltar la utilidad diagnóstica de la tomografía computarizada con aumento de contraste de fase tardía (CECT) para diferenciar la PCD de la oclusión arterial aguda.
- Para presentar un informe de caso de un paciente anciano diagnosticado con PCD utilizando CECT.
- Describir el manejo exitoso de la PCD a través de la intervención quirúrgica y la anticoagulación.
Principales métodos:
- Informe de caso de un hombre de 86 años que presentaba síntomas sugerentes de isquemia aguda de las extremidades.
- Imágenes de diagnóstico que utilizan tomografía computarizada con contraste de fase retardada (CECT, por sus siglas en inglés).
- El tratamiento incluyó una trombectomía venosa quirúrgica de emergencia y posterior terapia anticoagulante.
Principales resultados:
- El CECT distinguió con precisión Phlegmasia cerulea dolens de la oclusión arterial aguda en el caso presentado.
- El paciente se sometió con éxito a una trombectomía venosa quirúrgica de emergencia.
- Se inició la terapia anticoagulante postoperatoria, lo que condujo a un resultado positivo.
Conclusiones:
- La CECT de fase tardía es una herramienta valiosa para el diagnóstico diferencial de emergencias vasculares que amenazan a las extremidades.
- La trombectomía quirúrgica venosa seguida de anticoagulación es una estrategia de tratamiento eficaz para la EPC.
- El diagnóstico y la intervención inmediatos son clave para el manejo de la PCD y la prevención de la pérdida de extremidades.
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