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Vol. 31. Issue 5.
Pages 249-252 (September - October 2020)
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Vol. 31. Issue 5.
Pages 249-252 (September - October 2020)
Caso clínico
Instrumentación vertebral y flegmasía cerúlea dolens
Vertebral instrumentation and Phlegmasia cerulea dolens
Felipe Sainz Gonzáleza, Pablo Palacios Cabezasb, Alejandro Lorente Gómezc,
Corresponding author
allogoholmes@hotmail.com

Autor para correspondencia.
, Álvaro Sánchez Galána, Rafael Lorente Morenod
a Angiología y Cirugía Vascular, Hospitales Universitarios «Gómez Ulla» y «Sanchinarro», Madrid, España
b Servicio de Cirugía Ortopédica y Traumatología, Hospital de Sanchinarro, HM Hospitales, Madrid, España
c Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Ramón y Cajal, Madrid, España
d Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario de Badajoz, Badajoz, España
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Resumen

La flegmasía cerúlea dolens es un estado muy infrecuente, secundario a trombosis venosa profunda, de origen multietiológico, que afecta usualmente a las extremidades inferiores. Se presenta con dolor en miembro inferior y edema rápidamente progresivo que puede comprometer la perfusión de la extremidad, pudiendo llevar a gangrena, amputación e incluso a la muerte. Se presenta un caso de flegmasía extremadamente raro secundario a trombosis venosa profunda masiva del eje iliofemoral izquierdo provocado por un hematoma crónico compresivo de origen traumático por cizallamiento del tornillo de S1 en una paciente intervenida hacia 3 meses de hernia discal lumbar mediante artrodesis e instrumentación vertebral L5-S1. Este artículo muestra la necesidad de realizar un escrupuloso escrutinio de los tornillos tanto intra como postoperatoriamente cuando nos encontramos cerca de los grandes vasos.

Palabras clave:
Flegmasía
Trombosis venosa
Instrumentación vertebral
Abstract

Phlegmasia cerulea dolens is a very infrequent condition secondary to a deep venous thrombosis of multietiological origin usually affecting the lower extremities. It presents with pain and edema in the lower limb rapidly progressive that can compromise the perfusion of the limb, being able to cause gangrene, amputation and even death. We present an extremely rare case of a phlegmasia secondary to a massive deep venous tombosis of the left iliofemoral axis caused by chronic compressive hematoma of a traumatic origin due to a S1 screw shearing in a patient operated three months ago of a lumbar herniated disc through a L5-S1 fussion. This article shows the need to perform a scrupulously scrutinize of the screws both intra and postoperatively when we are close to the great vessels.

Key words:
Phlegmasia
Deep venous thrombosis
Vertebral fussion

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