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J Hand Surg Am ; 47(7): 693.e1-693.e3, 2022 07.
Article in English | MEDLINE | ID: covidwho-1275479

ABSTRACT

A 54-year-old woman with leukemia presented with coronavirus disease 2019 and a right upper-extremity indwelling peripherally inserted central catheter line for chemotherapy administration. On hospital admission day 9, she developed acute right upper-extremity edema and pain. Ultrasound demonstrated complete superficial and deep venous thrombosis up to the proximal subclavian vein. Her examination result was consistent with acute phlegmasia cerulea dolens and compartment syndrome, but respiratory instability prevented transfer and vascular surgery intervention. Instead, we performed bedside fasciotomies and administered therapeutic heparin, and the limb was salvaged. This case underscores the potential for successful limb salvage in patients with phlegmasia in the setting of coronavirus disease 2019 via compartment release and therapeutic anticoagulation.


Subject(s)
COVID-19 , Compartment Syndromes , Sepsis , Thrombophlebitis , Venous Thrombosis , Compartment Syndromes/etiology , Compartment Syndromes/surgery , Extremities , Female , Humans , Middle Aged , Thrombophlebitis/diagnosis , Thrombophlebitis/etiology , Thrombophlebitis/therapy , Venous Thrombosis/diagnostic imaging , Venous Thrombosis/etiology , Venous Thrombosis/surgery
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