Phlegmasia alba dolens - Revision history

Mholtz at 05:24, 27 September 2019

2019-09-27T05:24:14Z

← Older revision		Revision as of 05:24, 27 September 2019
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	==Disposition==		==Disposition==
	*Admit		*Admit

	==References==		==References==
	<references/>		<references/>
	*Dardik A. (2014, Feb 25). Phlegmasia Alba and Cerulea Dolens. eMedicine. Retrieved 12/21/2014 from http://emedicine.medscape.com/article/461809-overview.
	*Rosen's Emergency Medicine 8th edition. 2013. Chapter: Peripheral Arteriovascular Disease p. 1147.
	*Lip GY, et al. Overview of the treatment of lower extremity deep vein thrombosis (DVT). In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 21, 2014.

	[[Category:Cardiology]]		[[Category:Cardiology]]
	[[Category:Vascular]]		[[Category:Vascular]]

ClaireLewis at 16:58, 25 September 2019

2019-09-25T16:58:32Z

← Older revision		Revision as of 16:58, 25 September 2019
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	*Age 50-60s		*Age 50-60s
	*Malignancy (20-40%)		*Malignancy (20-40%)
	*Pregnancy		*[[Pregnancy]]
	*Inherited thrombophilia		*Inherited thrombophilia
	*Trauma/surgery		*[[Trauma]]/surgery
	*10% idiopathic in patients without risk factors		*10% idiopathic in patients without risk factors

Line 24:		Line 24:
	==Differential Diagnosis==		==Differential Diagnosis==
	*Arterial embolism		*Arterial embolism
	*Phlegmasia cerulea dolens		*[[Phlegmasia cerulea dolens]]
	*[[DVT]]		*[[DVT]]
	*Cellulitis		*[[Cellulitis]]
	*Lymphedema		*[[Lymphedema]]
	*Venous valvular insufficiency		*Venous valvular insufficiency
	*Superficial thrombophlebitis		*[[Superficial thrombophlebitis]]
			{{Template:Calf pain DDX}}

	==Evaluation==		==Evaluation==
	*Clinical diagnosis		*Clinical diagnosis
	*Duplex US		*Duplex [[Ultrasound: DVT\|US]]
	*Contrast venography		*Contrast venography
	*MRV		*MRV
Line 40:		Line 42:
	**Steep limb elevation		**Steep limb elevation
	**Fluid resuscitation		**Fluid resuscitation
	**Heparin: 80-100U/kg followed by infusion of 15-18U/kg/hr		**[[Heparin]]: 80-100U/kg followed by infusion of 15-18U/kg/hr
	**Vascular surgery consult		**Vascular surgery consult
	*If conservative therapy fails, can consider:		*If conservative therapy fails, can consider:
	**~~Thrombolytic~~: Alteplase (1mg/min to total of 50mg) distal to thrombus		**[[Thrombolysis]]: Alteplase (1mg/min to total of 50mg) distal to thrombus
	**Interventional radiology consult for emergent catheter-directed thrombolysis		**Interventional radiology consult for emergent catheter-directed thrombolysis
	**Thrombectomy		**Thrombectomy

	==Disposition==		==Disposition==
	*Admit		*Admit

SLuckettG: /* Clinical Features */

2019-03-08T19:29:46Z

Clinical Features

← Older revision		Revision as of 19:29, 8 March 2019
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	*Edema		*Edema
	*White appearance/blanching (alba)		*White appearance/blanching (alba)
	*~~Progresses~~ to [[phlegmasia cerulea dolens]]		*May progress to [[phlegmasia cerulea dolens]]
	**Superficial venous system is occluded, resulting in no venous outflow		**Superficial venous system is occluded, resulting in no venous outflow

SLuckettG: /* Background */

2019-03-08T19:29:17Z

Background

← Older revision		Revision as of 19:29, 8 March 2019
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	==Background==		==Background==
	*"Milk/White Leg"		*"Milk/White Leg"
	*Massive iliofemoral occlusion		*Massive iliofemoral occlusion due to venous thromboembolism
	*Spares collateral veins		*Spares collateral veins
	*Lack of venous congestion		*Lack of venous congestion
Line 11:		Line 11:
	*Malignancy (20-40%)		*Malignancy (20-40%)
	*Pregnancy		*Pregnancy
	*Idiopathic (10%)
	*Inherited thrombophilia		*Inherited thrombophilia
	*Trauma/surgery		*Trauma/surgery
			*10% idiopathic in patients without risk factors

	==Clinical Features==		==Clinical Features==

Rossdonaldson1: /* Clinical Features */

2018-11-26T23:57:02Z

Clinical Features

← Older revision		Revision as of 23:57, 26 November 2018
Line 19:		Line 19:
	*Edema		*Edema
	*White appearance/blanching (alba)		*White appearance/blanching (alba)
	*Progresses to phlegmasia cerulea dolens		*Progresses to [[phlegmasia cerulea dolens]]
	**Superficial venous system is occluded, resulting in no venous outflow		**Superficial venous system is occluded, resulting in no venous outflow

	==Differential Diagnosis==		==Differential Diagnosis==
	*Arterial embolism		*Arterial embolism

Rossdonaldson1: /* Risk Factors */

2018-11-26T23:56:44Z

Risk Factors

← Older revision		Revision as of 23:56, 26 November 2018
Line 7:		Line 7:
	{{Venous thromboembolism types}}		{{Venous thromboembolism types}}

	==Risk Factors==		===Risk Factors===
	*Age 50-60s		*Age 50-60s
	*Malignancy (20-40%)		*Malignancy (20-40%)
Line 14:		Line 14:
	*Inherited thrombophilia		*Inherited thrombophilia
	*Trauma/surgery		*Trauma/surgery

	==Clinical Features==		==Clinical Features==
	*Pain		*Pain

Rossdonaldson1: /* Workup */

2018-11-26T23:56:08Z

Workup

← Older revision		Revision as of 23:56, 26 November 2018
Line 28:		Line 28:
	*Venous valvular insufficiency		*Venous valvular insufficiency
	*Superficial thrombophlebitis		*Superficial thrombophlebitis
	==~~Workup~~==		==Evaluation==
	*Clinical diagnosis		*Clinical diagnosis
	*Duplex US		*Duplex US
	*Contrast venography		*Contrast venography
	*MRV		*MRV

	==Management==		==Management==
	*Conservative management		*Conservative management

Ostermayer: Text replacement - "DVT" to "DVT"

2017-01-27T17:07:22Z

Text replacement - "*DVT" to "*DVT"

← Older revision		Revision as of 17:07, 27 January 2017
Line 23:		Line 23:
	*Arterial embolism		*Arterial embolism
	*Phlegmasia cerulea dolens		*Phlegmasia cerulea dolens
	*DVT		*[[DVT]]
	*Cellulitis		*Cellulitis
	*Lymphedema		*Lymphedema

Neil.m.young: Text replacement - "* " to "*"

2016-07-04T13:29:09Z

Text replacement - "* " to "*"

← Older revision		Revision as of 13:29, 4 July 2016
Line 1:		Line 1:
	==Background==		==Background==
	* "Milk/White Leg"		*"Milk/White Leg"
	* Massive iliofemoral occlusion		*Massive iliofemoral occlusion
	* Spares collateral veins		*Spares collateral veins
	* Lack of venous congestion		*Lack of venous congestion

	{{Venous thromboembolism types}}		{{Venous thromboembolism types}}

	==Risk Factors==		==Risk Factors==
	* Age 50-60s		*Age 50-60s
	* Malignancy (20-40%)		*Malignancy (20-40%)
	* Pregnancy		*Pregnancy
	* Idiopathic (10%)		*Idiopathic (10%)
	* Inherited thrombophilia		*Inherited thrombophilia
	* Trauma/surgery		*Trauma/surgery
	==Clinical Features==		==Clinical Features==
	* Pain		*Pain
	* Edema		*Edema
	* White appearance/blanching (alba)		*White appearance/blanching (alba)
	* Progresses to phlegmasia cerulea dolens		*Progresses to phlegmasia cerulea dolens
	** Superficial venous system is occluded, resulting in no venous outflow		**Superficial venous system is occluded, resulting in no venous outflow
	==Differential Diagnosis==		==Differential Diagnosis==
	* Arterial embolism		*Arterial embolism
	* Phlegmasia cerulea dolens		*Phlegmasia cerulea dolens
	* DVT		*DVT
	* Cellulitis		*Cellulitis
	* Lymphedema		*Lymphedema
	* Venous valvular insufficiency		*Venous valvular insufficiency
	* Superficial thrombophlebitis		*Superficial thrombophlebitis
	==Workup==		==Workup==
	* Clinical diagnosis		*Clinical diagnosis
	* Duplex US		*Duplex US
	* Contrast venography		*Contrast venography
	* MRV		*MRV
	==Management==		==Management==
	* Conservative management		*Conservative management
	** Steep limb elevation		**Steep limb elevation
	** Fluid resuscitation		**Fluid resuscitation
	** Heparin: 80-100U/kg followed by infusion of 15-18U/kg/hr		**Heparin: 80-100U/kg followed by infusion of 15-18U/kg/hr
	** Vascular surgery consult		**Vascular surgery consult
	* If conservative therapy fails, can consider:		*If conservative therapy fails, can consider:
	** Thrombolytic: Alteplase (1mg/min to total of 50mg) distal to thrombus		**Thrombolytic: Alteplase (1mg/min to total of 50mg) distal to thrombus
	** Interventional radiology consult for emergent catheter-directed thrombolysis		**Interventional radiology consult for emergent catheter-directed thrombolysis
	** Thrombectomy		**Thrombectomy
	==Disposition==		==Disposition==
	*Admit		*Admit
	==References==		==References==
	<references/>		<references/>
	* Dardik A. (2014, Feb 25). Phlegmasia Alba and Cerulea Dolens. eMedicine. Retrieved 12/21/2014 from http://emedicine.medscape.com/article/461809-overview.		*Dardik A. (2014, Feb 25). Phlegmasia Alba and Cerulea Dolens. eMedicine. Retrieved 12/21/2014 from http://emedicine.medscape.com/article/461809-overview.
	*Rosen's Emergency Medicine 8th edition. 2013. Chapter: Peripheral Arteriovascular Disease p. 1147.		*Rosen's Emergency Medicine 8th edition. 2013. Chapter: Peripheral Arteriovascular Disease p. 1147.
	*Lip GY, et al. Overview of the treatment of lower extremity deep vein thrombosis (DVT). In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 21, 2014.		*Lip GY, et al. Overview of the treatment of lower extremity deep vein thrombosis (DVT). In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 21, 2014.

Ostermayer: Text replacement - "Category:Cards" to "Category:Cardiology"

2016-03-22T13:53:14Z

Text replacement - "Category:Cards" to "Category:Cardiology"

← Older revision		Revision as of 13:53, 22 March 2016
Line 51:		Line 51:
	*Lip GY, et al. Overview of the treatment of lower extremity deep vein thrombosis (DVT). In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 21, 2014.		*Lip GY, et al. Overview of the treatment of lower extremity deep vein thrombosis (DVT). In: Post T, ed. UpToDate. Waltham, Mass.: UpToDate; 2014. www.uptodate.com. Accessed December 21, 2014.

	[[Category:~~Cards~~]]		[[Category:Cardiology]]
	[[Category:Vascular]]		[[Category:Vascular]]