Massive DVT (phlegmasia Cerulea Dolens)

Your Path

  • Massive DVT (phlegmasia cerulea dolens)


  • Unusual, massive proximal dvt

Risk Factors

  • Hypercoaguable state
  • External compression of iliac or proximal femoral veins


  • Pain
  • Acute, extensive leg swelling
  • Evidence arterial insufficiency/ischemia secondary to increased tissue pressure

Physical Exam Findings

  • Marked asymmetric edema, extending to proximal leg (thigh)
  • Diminished pulses
  • Delayed capillary refill, cool, dusky/bluish skin appearance