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December 9, 1950

PHLEGMASIA CERULEA DOLENS: Massive Venous Thrombosis in an Extremity Associated with Shock

Author Affiliations


From the Department of Surgery, Michael Reese Hospital.

JAMA. 1950;144(15):1257-1258. doi:10.1001/jama.1950.62920150002009

Phlegmasia cerulea dolens, or "blue phlebitis," is an acute fulminating form of deep venous thrombosis first described by Trémolières and VéRan1 in 1929. Clinically there is sudden severe pain in a part of an extremity which quickly spreads to involve the whole limb. This is associated with pronounced edema of the foot and leg and later of the thigh. The most striking change is the severe cyanosis and the purpuric areas and petechiae which develop early and produce a most alarming picture. The limb becomes numb and cold, and the peripheral pulses disappear. Associated with these local changes there is rapid development of circulatory collapse and the clinical picture of shock. In the severer cases death results. In the less severely affected patients who survive, the disease follows the usual course of iliofemoral venous thrombosis with gradual disappearance of the edema and the purpuric areas and return of the