Phlegmasia coerulea dolens - Altmeyers Encyclopedia

Synonym(s)

acute massive venous occlusion (Veal); Phlegmasia rubra dolens Sowing knife; Pseudoembolic Nicole; Venous occlusion acute massive

Definition
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Massive phlebothrombosis, especially in the iliac or femoral veins with stasis-related ischemia of the microcirculation (venous reflux blocked) Rarely arterial-ischemic syndrome grafted.

Clinical features
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Acute painful swelling of a limb with increasing cyanotic discoloration (phlébite bleue), motor weakness and moderate hypaesthesia. As a consequence, rapid development of the cyanotic edema and development of gangrene. Signs of hypovolemic shock. Increasing anaemia.

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Diagnosis
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Ultrasound Doppler examination.

Complication(s)
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volume deficiency shock, rhabdomyolysis with acute renal failure, gangrene

Therapy
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Intensive medical care. Thrombectomy with Fogarty catheter by surgeons, embolism protection with V. cava-clip.S.a. phlebothrombosis.alternatively: fibrinolysis therapy (see below fibrinolytics). Post-operative anticoagulation (Marcumar) for at least 6 months. Ultima ratio: border zone amputation.