Abstract
Severe excruciating pain, massive edema, bluish purple cyanosis, and diminished arterial flow to an extremity are the clinical manifestations of phlegmasia cerulea dolens. It is frequently associated with malignant disease, trauma, infection, and postoperative and post-partum states. The basic pathologic process is massive obstructive venous thrombosis and the treatment of choice is early thrombectomy. If the general condition of the patient is poor, conservative measures such as elevation of the involved extremity, intravenously administered heparin, and sympathetic nerve blocks are of help while preparing the patient for the operation. Our experience with four patients who had phlegmasia cerulea dolens is reported. Three of these patients received thrombectomy early with good results and amputation was necessitated in one patient seen late. One of the patients treated by thrombectomy died subsequently from recurrent pulmonary thromboemboli which in retrospect were discovered to be present soon after thrombectomy.
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