J Acute Care Surg.  2017 Oct;7(2):87-89. 10.17479/jacs.2017.7.2.87.

Successful Endovascular Management of Post-Traumatic Phlegmasia Cerulea Dolens from Rupture of the External Iliac Vein

• Park CY
• Cho HM
• Yeo KH
• Seok JP
• Lee CK

• KMID: 2395638
• DOI: http://doi.org/10.17479/jacs.2017.7.2.87

Abstract

We report a rare case of a 47-year-old male with posttraumatic phlegmasia cerulea dolens caused by a ruptured right external iliac vein and treated with an endovascular venous stent graft. The patient was the victim of motor vehicle accident, and suffered direct injuries to the head and abdomen. The patient had a cyanotic and swollen right lower leg. Abdominal and lower extremity computed tomography angiography revealed a large retroperitoneal hematoma caused by a ruptured right external iliac vein, and grade I liver injury. The right external iliac vein rupture was successfully treated with a venous stent graft, followed by inferior vena cava filtering, because a venous thrombus was identified below the stent graft. He initially was hemodynamically unstable but recovered following treatment. The patient was comatose when presenting at the emergency department. He was discharged, fully recovered, on hospital day 18.

Keyword

Posttraumatic phlegmasia cerulea dolens; Ruptured external iliac vein; Endovascular venous stent graft; Inferior vena cava filtering; Venous thrombus

MeSH Terms

Abdomen
Angiography
Blood Vessel Prosthesis
Coma
Emergency Service, Hospital
Head
Hematoma
Humans
Iliac Vein*
Leg
Liver
Lower Extremity
Male
Middle Aged
Motor Vehicles
Rupture*
Thrombosis
Vena Cava, Inferior