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Question 8#

Phlegmasia cerulea dolens is best described as:

A. Asymptomatic, but extensive DVT
B. Isolated popliteal vein thrombosis
C. Extensive DVT of the major axial deep venous channels of the lower extremity potentially complicated by venous gangrene and/or the need for amputation
D. Painless lower extremity swelling

Correct Answer is C

Comment:

Clinical symptoms may worsen as DVT propagates and involves the major proximal deep veins. Extensive DVT of the major axial deep venous channels of the lower extremity with relative sparing of collateral veins causes a condition called phlegmasia cerulea doZens (Fig. below). This condition is characterized by pain and pitting edema with associated cyanosis. When the thrombosis extends to the collateral veins, massive fluid sequestration and more significant edema ensue, resulting in a condition known as phlegmasia alba do lens. The affected extremity in phlegmasia alba do lens is extremely painful and edematous and pale secondary to arterial insufficiency from dramatically elevated below lower knee compartment pressures. Both phlegmasia cerulean dolens and phlegmasia alba dolens can be complicated by venous gangrene and the need for amputation.

Phlegmasia cerulea dolens of the left leg. Note the bluish discoloration