By Gary M. White, MD

Phlegmasia cerulea dolens (painful blue edema) is a rare, severe form of deep venous thrombosis which results in acute blockage of venous return.


Pain is felt initially in the groin, thigh, and leg. Rapidly progressive edema and cyanosis then develop and the pain may be excruciating. The skin is shiny and taut and bulla may develop. If untreated, necrosis of the toes develops 4-8 days later. The left leg is more commonly affected.


Consultation with a vascular surgeon is indicated. In the past, anticoagulation and thrombectomy have been done acutely.


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