1/5. Venous gangrene of lower extremities and staphylococcus aureus sepsis.This is a study of the venous gangrene of lower extremities and staphylococcus aureus sepsis. We report on a premature infant who developed phlegmasia cerulea dolens (PCD) in both lower extremities in association with S. aureus sepsis, resulting in gangrene of the right foot. Non-pitting edema and cyanosis of the digits of the right lower extremity were noted 48 hours after hypotension and severe shock due to S. aureus sepsis. Intravenous antibiotics, isotonic fluids, and heparin were administered. Twenty-four hours later, edema and ischemic changes of the first and fifth left toes were also noted. Doppler flow study showed flow signals in both right and left popliteal arteries. However, there were no Doppler signals in neither right nor left popliteal vein. Emergency fasciotomies were performed on both lower limbs. The progression of the gangrene was limited to the right foot. There was complete resolution of PCD in both lower extremities. To the best of our knowledge, the association of S. aureus sepsis with PCD and venous gangrene in an infant has not been reported previously. This case illustrates the need for early recognition of PCD and aggressive intervention.- - - - - - - - - - ranking = 1keywords = phlegmasia, dolens (Clic here for more details about this article) |
2/5. Upper extremity venous gangrene following coronary artery bypass. A case report and review of the literature.Acute symptomatic upper extremity deep vein thrombosis (DVT) are estimated to account for only 2-4% of all deep vein thrombosis. Upper extremity DVT leading to phlegmasia cerulea dolens (PCD) occurs in an estimated 2-5% of these cases. Progression of PCD to venous gangrene is extremely rare with only 16 previously reported cases in the literature. Only 7 of the cited cases document significant tissue loss. This report describes a 61-year-old male who developed upper extremity DVT complicated by PCD which led to venous gangrene and limb loss.- - - - - - - - - - ranking = 1keywords = phlegmasia, dolens (Clic here for more details about this article) |
3/5. Venous gangrene (phlegmasia caerulea dolens) complicating heart failure from severe mitral stenosis--a case history.gangrene of the left upper limb was found to complicate severe mitral stenosis presenting with heart failure in a sixty-eight-year-old woman with a documented left atrial thrombus. Arterial obstruction as the cause of gangrene was excluded by Doppler-assisted assessment of the peripheral pulses. Venous gangrene can complicate severe mitral stenosis and must be distinguished from arterial embolization, in which urgent surgical treatment is imperative.- - - - - - - - - - ranking = 4keywords = phlegmasia, dolens (Clic here for more details about this article) |
4/5. The role of thrombolytic therapy in the management of phlegmasia caerulea dolens.Two cases of phlegmasia caerulea dolens with peripheral venous gangrene treated with streptokinase are presented. Both patients had excellent results, beyond expectation. The literature is reviewed and the symptomatology, aetiology, pathogenesis and current thoughts on treatment are discussed.- - - - - - - - - - ranking = 5keywords = phlegmasia, dolens (Clic here for more details about this article) |
5/5. Venous gangrene of the extremities.OBJECTIVE: To review the rare clinical condition of venous gangrene of the extremities, particularly in association with malignant disease; to develop a treatment scheme for this difficult condition. DATA SOURCES: Surgical articles on phlegmasia cerulea dolens, venous gangrene and other forms of noninfectious, nonarterial gangrene of the extremities from 1937 to the present were identified from published indexes and computer databases; experience with four additional cases treated by the authors is incorporated. STUDY SELECTION: Studies selected for detailed review include those involved directly with venous gangrene and its investigation and treatment, and those relating to investigation of clinically similar conditions. DATA EXTRACTION: Because of the rarity of venous gangrene, much of the available literature is descriptive, involves small numbers of cases and describes only limited experience with investigation and treatment; data extraction was done by a single reviewer. DATA SYNTHESIS: Because of advances in diagnostic technology and thrombosis research, the assessment of suspected venous gangrene has changed significantly in recent years. Despite these advances, the prognosis for patients with this condition continues to be poor. The possible confounding roles of paradoxical reactions to anticoagulants and of primary hypercoagulable states are considered. CONCLUSIONS: Objective demonstration of extensive thrombosis of the large veins of the involved extremity remains central to the diagnosis. The presence and stage of any associated malignant lesion must be rapidly determined to allow planning for further treatment. Because conventional anticoagulation frequently fails, it may be necessary to consider less well-established modes of therapy.- - - - - - - - - - ranking = 1keywords = phlegmasia, dolens (Clic here for more details about this article) |