Overview
Definition Of Phlegmasia Cerulea Dolens
Phlegmasia cerulea dolens is an uncommon, severe form of deep venous thrombosis (blood clots in the vein), usually in the upper leg.
Symptoms:
Pain, swelling , and bluish-skin coloring affect the area below the blocked vein.
Causes
Deep venous thrombosis (DVT) mainly affects the large veins in the lower leg and thigh. The clot can block blood flow. If the clot breaks off and moves through the bloodstream, it can get stuck in the brain, lungs, heart, or other area, leading to severe damage.
Risks for DVT include:
- Bedrest
- Cigarette smoking
- Fractures
- Giving birth within the last 6 months
- Medications such as estrogen and birth control pills
- Obesity
- Recent surgery (especially hip, knee, or female reproductive organ surgery)
- Sitting for a long time, such as on a long plane or car trip
You're also more likely to develop DVT if you have any of the following conditions:
- Blood that is more likely to clot (hypercoagulability)
- Cancer
- Overproduction of red blood cells in bone marrow (polycythemia vera) or related conditions
Symptoms
- Changes in skin color (redness) in one leg
- Increased warmth in one leg
- Leg pain in one leg
- Leg tenderness in one leg
- Swelling (edema) of one leg
Treatment
For years, the standard treatment has been a medication called heparin, which stops blood clots from forming. This type of medicine is called an anticoagulant (also known as a blood thinner).
If heparin is given continuously through a vein (IV), you must stay in the hospital. However, newer forms of heparin that can be given by injection once or twice a day can sometimes be used. You may not need to stay in the hospital as long, or at all, if you are prescribed this newer form of heparin.
The drug warfarin is usually prescribed along with heparin. Warfarin is taken by mouth and is usually used for long-term therapy. It takes several days to fully work. Heparin is continued until the warfarin has been fully effective for at least 24 hours. People usually take warfarin for a minimum of 3 months, but sometimes they must take it for the rest of their lives, depending on their risk for another clot.
You will need frequent lab tests to check the thickness of your blood when you first start taking warfarin. This lets your health care provider properly adjust your dose.
In rare cases, surgery may be needed if medicines do not work. Surgery may involve:
- Placement of a filter in the body's largest vein to prevent blood clots from traveling to the lungs
- Removal of a large blood clot from the vein or injection of clot-busting medicines
Complications:
Continued clotting leads to increased swelling. The swelling can interfere with blood flow. This complication is called phlegmasia alba dolens. It may lead to tissue death (gangrene) and the need for amputation.
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