It is therefore logical to deliver the lytic agent to the capillary bed by the arterial route. Phlegmasia cerulea dolens phlebitis blue of gregoire. Flegmasia cerulea dolens quando existe cianose, com grave comprometimento circulatorio 1 flegmasia alba dolens quando nao ha cianose, mas sim palidez devido a isquemia secundaria ao compromisso do fluxo arterial por cesse do retorno venoso. Phlegmasia cerulean dolens is a severe form of deep venous thrombosis characterized by severe venous outflow obstruction, marked limb swelling, pain, bluish discoloration, and even venous gangrene if the condition is untreated. This form of phlebitis is known by a number of names, most of which are descriptive of its clinical findings. Phlegmasia alba and cerulea dolens clinical presentation. A multimodal therapeutic approach to phlegmasia cerulea. Phlegmasia cerulea dolens pcd is more advanced and considered a precursor of frank venous gangrene. Phlegmasia cerulea dolens is a rare but severe form of deep venous thrombosis which results from extensive thrombotic occlusion of the major extremity veins and their collaterals. Phlegmasia cerulea dolens with compartment syndrome ncbi. Phlegmasia cerulea dolens describes clot formation in the venous system over a large area.
Diagnosis of pulmonary embolism by multidetector ct alone or combined with venous ultrasonography of the leg. The phlegmasia cerulla dolens is isquemic venous thrombosis. Phlegmasia cerulea dolens symptoms, treatments and. Phlegmasia alba dolens definition of phlegmasia alba. Acousticassisted catheterdirected thrombolytic therapy. Phlegmasia cerulea dolens pcd is a rare form of massive venous thrombosis of the lower extremities associated with a high degree of morbidity including venous gangrene, compartment syndrome, and. Pcd is defined as phlegmasia cerulea dolens frequently. Phlegmasia cerulea dolens definition of phlegmasia cerulea. Aug, 2018 phlegmasia cerulea dolens pcd is more advanced and considered a precursor of frank venous gangrene. Symptoms severe pain, rapid swelling, and bluishskin coloring affect the area below the blocked vein. Phlegmasia cerulea dolens definition phlegmasia cerulea dolens is an uncommon, severe form of deep venous thrombosis blood clots in the vein.
It compounds with pulmonary embolism pe and deep vein thrombosis dvt. The code is valid for the year 2020 for the submission of hipaacovered transactions. A case of phlegmasia cerulea dolens somasamudra p broomfield hospital, chelmsford, united kingdom. The icd10cm alphabetical index is designed to allow medical coders to look up various medical terms and connect them with the appropriate icd codes.
Lewis and charles short 1879 a latin dictionary, oxford. Phlegmasia cerulea dolenssuccessful treatment by vena cava ligation. Phlegmasia cerulea dolens pcd is a rare disease entity involving complete thrombotic occlusion of venous outflow in an extremity, and is considered a vascular emergency. Rapid deterioration and death caused by bilateral phlegmasia. Abouzamzam jr, md, loma linda, calif phlegmasia cerulea dolens is a rare but serious complication of deep venous thrombosis, which can lead to arterial compromise, tissue ischemia, and gangrene. Scvir, 1995 phlegmasia cerulea dolens pcd is a fulminant form of peripheral venous thrombosis characterized by massive edema, severe pain, and cyanosis. Jan 19, 2018 phlegmasia cerulea dolens is an uncommon, severe form of deep venous thrombosis blood clots in the vein. Read more about symptoms, diagnosis, treatment, complications, causes and prognosis. Phlegmasia cerulea dolens is a rare but severe form of deep venous thrombosis which results from extensive thrombotic occlusion of the major extremity veins and their collaterals pathogenesis. Only 40% of ambulatory ed patients with pe have concomitant dvt. Phlegmasia cerulea dolens definition at, a free online dictionary with pronunciation, synonyms and translation. It is characterized by sudden severe pain, swelling, cyanosis and edema.
Most cases described encompass the lower extremities. Trends in management of phlegmasia te d cerulea dolens. Phlegmasia cerulea dolens pcd is a severe presentation of massive dvt, and it is often associated with extremity catheterdirected thrombolytic therapy in deep venous thrombosis of the lower extremity. It is characterized by sudden severe pain, swelling, cyanosis and edema of the affected limb. Phlegmasia cerulea dolens information including symptoms, causes, diseases, symptoms, treatments, and other medical and health issues. There are 2 terms under the parent term phlegmasia alba dolens in the icd10cm alphabetical index. It was first described by hildanus in the 16 th century. Phlegmasia cerulea dolens pcd is an uncommon but potentially lifethreatening. Phlegmasia cerulea dolens is preceded by a condition called phlegmasia alba dolens.
Phlegmasia cerulea dolens is one of the infrequent but most severe forms of venous thrombotic disease. Cyanosis is pathognomic for phlegmasia cerulea dolens. Phlegmasia cerulea dolens pcd is an uncommon complication of deep venous thrombosis, which results from extensive thrombotic occlusion of the major and collateral veins of an extremity usually the legs. Lewis 1891 an elementary latin dictionary, new york. Find phlegmasia cerulea dolens information, treatments for phlegmasia cerulea dolens and phlegmasia cerulea dolens symptoms. Phlegmasia alba dolens pad and phlegmasia cerulea dolens pcd predominantly affect the lower extremities, with fewer than 5% of cases believed to involve the upper extremities.
Intervention is usually required in order to prevent gangrene. It is the consequence of complete obstruction of the venous drainage of a limb and may result in shock, distal gangrene 50%, pulmonary embolus, amputation. Phlegmasia cerulea dolens as a cause of gangrene of the. In the lower extremities, leftside involvement is three to four times more common. This occurs when the leg is swollen and white due to a clot in a deep vein that blocks blood flow. Fulminant phlegmasia cerulea dolens with concurrent cholangiocarcinoma and a lupus anticoagulant. A multimodal therapeutic approach to phlegmasia cerulea dolens in a pediatric patient isabella kuo, md, ajason smith, md,b and ahmed m.
There is a high risk of massive pulmonary embolism. Phlegmasia cerulea dolens phlegmasia erulea dolens pd erulea means lue referred to as painful lue leg rare condition that occurs in a rare, lifethreatening condition article pdf available in the scientific world journal 9. Phlegmasia cerulea dolens medhelp s phlegmasia cerulea dolens center for information, symptoms, resources, treatments and tools for phlegmasia cerulea dolens. Pathogenesis phlegmasia cerulea dolens is characterized by sudden severe pain, swelling, cyanosis and edema of the affected limb. Phlegmasia cerulea dolens is characterized by sudden severe pain, swelling, cyanosis and edema of the affected limb. Phlegmasia cerulea dolens pcd is a rare form of massive venous thrombosis of the lower extremities associated with a high degree of morbidity including venous gangrene, compartment syndrome, and arterial compromise. Phlegmasia cerulea dolens a limb threatening problem. Phlegmasia alba dolens definition of phlegmasia alba dolens. Historically, it commonly was seen pathophysiology. In phlegmasia alba dolens, the thrombosis involves only major deep venous channels of the extremity, therefore sparing collateral veins. Phlegmasia cerulea dolens definition of phlegmasia. Phlegmasia cerulea dolens is an uncommon, severe form of deep venous thrombosis blood clots in the vein.
Phlegmasia cerulea dolens of the upper extremity sciencedirect. Caso clinico flegmasia cerulea dolens, tratamiento endovascular. Phlegmasia alba dolens literally means painful white edema. Get a printable copy pdf file of the complete article 1. Phlegmasia cerulea dolens medical definition merriam. Deep vein thrombosis dvt is a condition that occurs when a blood clot forms in a vein deep inside a. Phlegmasia cerulea dolens radiology reference article. Phlegmasia cerulea dolens refers to congestion and cyanosis of a limb due to massive venous thrombosis. It has been used in the medical literature in reference to extreme cases of lower extremity deep venous thrombosis dvt that cause critical limb. Flegmasia cerulea dolens phlegmasia cerulla dolens dra. May 25, 2014 phlegmasia cerulea dolens pcd represents the most severe acute consequence of dvt.
Phlegmasia cerulea dolens a rare, lifethreatening condition article pdf available in the scientific world journal 9. It received the name milk leg because it was once thought to be caused by the metastasis of milk. Phlegmasia cerulean dolens is a severe form of deep venous thrombosis characterized by severe venous outflow obstruction, marked limb swelling. Phlegmasia cerulea dolens can rapidly progress to compartment syndrome and gangrene. Aug, 2018 phlegmasia alba dolens pad and phlegmasia cerulea dolens pcd predominantly affect the lower extremities, with fewer than 5% of cases believed to involve the upper extremities. Ikegami a, kuriyama s, matsukubo 2016 clinical picture of phlegmasia cerulea dolens an int j med 2812.
Phlegmasia alba and cerulea dolens diagnosis trip database. Lessne ml, bajwa j, hong k 2012 fatal reperfusion injury after thrombolysis for phlegmasia cerulea dolens. Phlegmasia alba dolens is part of a spectrum of diseases related to deep vein thrombosis. Phlegmasia alba and cerulea dolens diagnosis emedicine surgery, 2014. Historically, it was commonly seen during pregnancy and in mothers. Links to pubmed are also available for selected references. Phlegmasia cerulea dolens pcd represents the most severe acute consequence of dvt.
Prompt diagnosis along with pharmacological and endovascular therapy is the key to avoiding complications such as gangrene 4060 %, amputation 2050 %, and death 2540 %. Patients usually present with edema, pain, blanching and it may progress to gangrene and systemic shock in severe cases. In phlegmasia cerulea dolens the primary lesion is the thrombosis within the capillary bed leading to compartment syndrome and subsequent gangrene. Phlegmasia cerulea dolens pcd is an uncommon but potentially life threatening. Pad is known by the triad of edema, pain, and blanching alba without cyanosis. Phlegmasia cerulea dolens phlegmasia erulea dolens pd erulea means lue referred to as painful lue leg rare condition that occurs in phlegmasia coerulea dolensphlegmasia cerulea dolens. Pdf phlegmasia cerulea dolens is a rare form of massive proximal venous. Full text full text is available as a scanned copy of the original print version.