Ver el código de «Phlegmasia cerulea dolens»

==Background==
*"Painful Blue Leg"
*Massive iliofemoral occlusion due to venous thromboembolism
*Extensive vascular congestion and venous ischemia

===Risk Factors===
*Age 50-60s
*Malignancy (20-40%)
*Inherited thrombophilia
*[[Pregnancy]]
*[[Trauma]]/surgery
*Immobilization
*IVC filter
*10% of cases are idiopathic and occur in patients without risk factors

==Clinical Features==
[[File:PCD2016.jpg|thumb|Two hour history of phlegmasia cerulea dolens (left leg)]]
[[File:PMC5198769 vsi-32-201f1.png|thumb|At presentation (A) and post-op day 1 (B).]]
*Sudden severe leg pain
*Swelling and edema (bleb/bullae)
*Cyanosis
*Venous gangrene
*[[Compartment syndrome]]
*Arterial compromise
*[[Shock]]
*Often preceded by [[phlegmasia alba dolens]]

==Differential Diagnosis==
{{Venous thromboembolism types}}

*[[Cellulitis]]
*[[Lymphedema]]
*[[Venous valvular insufficiency]]
*[[Superficial thrombophlebitis]]

==Evaluation==
*Clinical diagnosis
*Duplex [[Ultrasound: DVT|US]]
*Contrast venography

==Management==
*For mild, non-gangrenous form: Conservative management
**Steep limb elevation
**Fluid resuscitation
**[[Heparin]]: 80-100U/kg followed by infusion of 15-18U/kg/hr
*Vascular surgery consult for emergent thrombectomy
*Interventional radiology consult for emergent catheter-directed thrombolysis
**[[Thrombolytic]] therapy: [[Alteplase]] (1mg/min to total of 50mg) distal to thrombus

==Disposition==
*Admit

==See Also==
*[[Venous thromboembolism]]

==External Links==


==References==
<references/>

[[Category:Cardiology]]
[[Category:Orthopedics]]
[[Category:Vascular]]