Which clinical history findings are characteristic of phlegmasia alba dolens (PAD) and phlegmasia cerulea dolens (PCD)?

Updated: Aug 13, 2018
  • Author: Cassius Iyad Ochoa Chaar, MD, MS, FACS; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Phlegmasia alba dolens (PAD) and phlegmasia cerulea dolens (PCD) predominantly affect the lower extremities, with fewer than 5% of cases believed to involve the upper extremities. In the lower extremities, left-side involvement is three to four times more common. PAD is known by the triad of edema, pain, and blanching (alba) without cyanosis.

The onset of symptoms may be gradual or fulminant. PAD precedes PCD in 50-60% of cases. With increasing cyanosis and progression, patients develop bullae, paresthesia, and motor weakness. Compartment syndrome may be precipitated by venous congestion. Venous gangrene and shock are the ultimate killers, and it is vital that patients be treated before reaching that stage.


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