Abstract

Background:
Phlegmasia cerulea dolens is a rare form of deep venous thrombosis (DVT) characterized by massive thrombosis of the veins in a lower extremity. Presumptive diagnosis is made on clinical grounds and confirmed with a point-of-care ultrasound (POCUS). Diagnostic failure can lead to limb loss and even death.
Case:
We describe a case of a 38 year-old male who presented to the emergency department (ED) with painful cyanotic swelling of his right lower extremity. Clinical exam and POCUS confirmed the diagnosis of phlegmasia cerulea dolens. This patient was successfully treated with anticoagulation and endovascular thrombolytic therapy.
Conclusion:
This report emphasizes the importance of early diagnosis of the disease with POCUS, which can confirm the diagnosis of phlegmasia within minutes of clinical suspicion. Additionally, it describes the successful therapy with anticoagulation and endovascular thrombolysis.

Key words: Phlegmasia cerulea dolens, DVT, POCUS, Cellulitis, gangrene, phlegmasia alba, venous thrombosis, amputation, thrombectomy