Phlegmasia Cerulea Dolens of the Upper Extremity:A Fatal Complication after Coronary Artery Bypass Grafting- Case Report and Review of the Literature

Phlegmasia cerulea dolens (PCD) is the term describing the painful venous congestion that results from near-total venous occlusion of a limb. Acute symptomatic upper extremity deep vein thrombosis (DVT) is estimated to account for only 2-4% of all DVTs. Upper extremity DVT leading to PCD occurs in an estimated 2-5% of these cases. Progression of PCD to venous gangrene is extremely rare with only a handful of cases reported in the literature. Only a few of the cited cases document significant tissue loss. This report describes a 56-year-old female who developed upper extremity DVT complicated by PCD, which led to venous gangrene and hemorrhagic cerebral stroke and death two weeks after coronary artery bypass graft (CABG) (Iranian Heart Journal 2007; 8 (4): 63-68).