Phlegmasia cerulea dolens

Abstract

SummaryThree cases of phlegmasia cerulea dolens are presented. An association with metastatic carcinoma was proved on postmortem examination in two patients; in the third case autopsy was not performed.After a brief historical survey of the literature concerning phlegmasia cerulea dolens, attention is drawn on the hemodynamic backgrounds of this condition. The basic pathologic process is the (nearly) total venous obstruction by thrombotic disease, resulting in a complete arrest of the bloodflow and collaps of the arterial wall (« critical closing pressure »).The clinical manifestations of « blue phlebitis », with the dramatic onset of excruciating pain, massive edema and cyanosis, are described. The frequent association of the condition with malignancies, posttraumatic, postoperative and postpartum states, is pointed out. It is of the utmost importance that a correct diagnosis versus primary arterial occlusive disease should be made.The need of performing early surgical thrombectomy, even without general ...