User:Mr. Ibrahem/Phlegmasia cerulea dolens
| Phlegmasia cerulea dolens | |
|---|---|
 | |
| A person with a two hour history of phlegmasia cerulea dolens (left leg, right side of image) | |
| Specialty | Vascular surgery |
| Symptoms | Swelling, pain, bluish discoloration[1] |
| Complications | Pulmonary embolism, compartment syndrome, gangrene, limb loss[1] |
| Risk factors | Cancer, hypercoagulability, venous stasis, surgery, major trauma, pregnancy, hormone therapy, immobilization[1] |
| Diagnostic method | Ultrasound[1] |
| Differential diagnosis | Arterial embolism, deep vein thrombosis, cellulitis, lymphedema[1] |
| Treatment | Leg elevation, anticoagulation, thrombolysis, thrombectomy[1] |
| Frequency | Uncommon[1] |
Phlegmasia cerulea dolens (PCD) is a severe form of deep venous thrombosis (DVT) that blocks outflow of blood from a limb.[1] Symptoms include swelling, pain, and bluish discoloration.[1] Most commonly the leg is affected, with less than 10% of cases affected the arm.[2] Complications may include pulmonary embolism, compartment syndrome, gangrene, and limb loss.[1]
Risk factors include cancer (30%), hypercoagulability, venous stasis, surgery, major trauma, pregnancy, hormone therapy, and immobilization; though in some cases none are present.[1] The underlying mechanism involves extensive blockage of an extremity vein by a clot such that blood is unable to leave.[1] Diagnosis is usually by ultrasound.[1] A similar, but less severe, condition that results in a white limb is known as phlegmasia alba dolens.[1]
It is a medical emergency.[1] Management involves raising the leg above the level of the heart, anticoagulants with heparin, and intravenous fluids.[1] The clot may be removed either by thrombolysis or thrombectomy.[1] The risk of death among those severely affected is as high as 40%.[1] Among those who survive post thrombotic syndrome is common.[1]
Phlegmasia cerulea dolens is uncommon.[1] Those most commonly affected are in their 50s or 60.[1] Males are more commonly affected than females.[1] The condition was first described and named in 1938 by Gregoire.[1] The term means "painful blue inflammation".[1]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r s t u v w x Gardella, L; Faulk, JB (January 2021). "Phlegmasia Alba And Cerulea Dolens". PMID 33085284. Archived from the original on 2021-08-28. Retrieved 2021-05-09.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Greenberg, Jacques; Troutman, Douglas A.; Shubinets, Valeriy; Dougherty, Matthew J.; Calligaro, Keith D. (February 2016). "Phlegmasia Cerulea Dolens in the Upper Extremity: A Case Report and Systematic Review and Outcomes Analysis". Vascular and Endovascular Surgery. 50 (2): 98–101. doi:10.1177/1538574416631645. ISSN 1538-5744. Archived from the original on 2021-08-28. Retrieved 2021-02-16.