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)