Phlegmasia cerulea dolens

The phlegmasia caerulea dolens (Greek phlegmasia inflammation, fever, Latin caeruleus blue; Latin dolere pain ) describes a rarely occurring, particularly severe form of venous thrombosis. This leads to the closure of all the veins of a cross section, so that the blood of the affected limb and can not flow away. Due to the drainage of the tissue pressure rises sharply and so it comes ultimately to the failure of the arterial supply. The event is accompanied by violent pains and represents a serious threat to the affected limb and the patient's life

Causes

By a disturbance of microcirculation in the affected limb will initially cause capillary thrombosis. The hemodynamically unfavorable situation leads to further thrombotic events in the larger venous vessels, which leads to the formation of edema. This increases the pressure in the affected area, the pressure on the venous and the arterial vascular system quickly and with a complete disruption of the blood supply.

Symptoms

Due to the reduced perfusion of the tissue and the high tissue pressure leads to severe pain and cold ( arterial insufficient supply ), and soft tissue swelling and a hard consistency ( edema) of the affected limb. Characteristic is the bluish discoloration due to the lack of oxygen supply to the extremity of the phlegmasia caerula dolens its name. In the further course, there is necrosis if action is not taken quickly.

Therapy

When phlegmasia caerulea dolens is an emergency situation that needs immediate attention. Here, the venous drainage path will be reopened by thrombectomy. To lower the tissue pressure fasciotomy may be indicated additionally. Because of thrombotic events is immediately with fibrinolysis and for the prophylaxis of thrombotic complications ( such as pulmonary embolism) to begin anticoagulation.

See

• Thrombosis
• Phlegmasia alba dolens

• Disease in angiology
• Disease in emergency medicine
• Disease in vascular surgery