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Ochsner journal · 2026

Phlegmasia Cerulea Dolens Secondary to Iliac Vein Compression From Posttransplant Hematoma Despite Anticoagulation.

Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Lim Tiffany Xiu Zhen, Parkerson Godfrey R, Barr Justin

Аннотация

BACKGROUND: Phlegmasia cerulea dolens is a rare, life- and limb-threatening form of venous thrombosis that is often seen in the setting of hypercoagulable states or mechanical obstruction.

CASE REPORT: We report the case of a 49-year-old female with a history of multiple thromboembolic events and a methylenetetrahydrofolate reductase mutation who, despite therapeutic anticoagulation, developed phlegmasia cerulea dolens following renal transplantation. Her postoperative course was marked by recurrent hemorrhage with rapidly reaccumulating subincision and perinephric hematomas, requiring 4 exploratory laparotomies for hematoma evacuation and graft evaluation. In addition, the patient underwent urgent endovascular suction thrombectomy for extensive iliofemoral thrombosis caused by extrinsic iliac vein compression.

CONCLUSION: This case highlights the complex interplay between bleeding and clotting in high-risk transplant recipients and the need for nuanced anticoagulation management. Although phlegmasia cerulea dolens is rare, clinicians must keep a high index of suspicion for the pathology, as early recognition and timely intervention can be both life- and limb-saving.

ИП Урсолов Владлен Сергеевич

ИНН 500118482352 · ОГРНИП 314500117700049

Реквизиты и контакты