A rare case of phlegmasia cerulea dolens complicated with iliac vein perforation

Abstract

Case ReportIJCR (2023) 7:287A rare case of phlegmasia cerulea dolens complicated with iliac vein perforationVenous thromboembolism (VTE) is a major healthcare problem in the world. It includes pulmonary embolism and deep vein thrombosis (DVT) that result in significant morbidity and mortality. Phlegmasia cerulea dolens (PCD) is a rare but potentially life-threatening severe form of acute DVT, which is characterized by marked swelling of the extremities with pain and cyanosis, and further leads to arterial ischemia due to venous hypertension and compartment syndrome, and ultimately cause gangrene with high amputation and mortality rates. However, there was rare case reported about PCD complicated with venous perforation. Herein, we report a scarce case of left iliofemoral DVT suffering from iliac vein perforation with extraperitoneal hematoma. Although this case treated by iliac vein stenting with cover stent and ultrasound-assisted thrombolysis (EKOS). Patient still finally received below the knee amputation due to reperfusion injury over distal foot despite great improved venous blood flow. Our case should be the first case of PCD complicated with venous perforation. This rare case reminds physicians that venous perforation is a possible complication of PCD and may lead to poor outcome. Early hemostasis by stenting and performing thrombectomy treatment as soon as possible is suggested to save the life and limb.