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Picture Quiz: An Acute, Blue, Swollen, Painful Leg (Answer)

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Case Outcome

Urgent Duplex ultrasound demonstrated ilio-femoral deep vein thrombosis (DVT) with involvement of the long saphenous and short saphenous superficial veins. Arterial Doppler waveforms were normal distally with no evidence of stenosis. The diagnosis was therefore Phlegmasia cerulea dolens (PCD), resulting from an extensive, proximal DVT with total or near total venous outflow occlusion.

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