May-Thurner Syndrome as a Cause of Phlegmasia Cerulea Dolens

Authors

Emma Pierce, Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion UniversityFollow
Anjeza Cipi, Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion UniversityFollow
Rebecca Dray, Macon & Joan Brock Virginia Health Sciences Eastern Virginia Medical School at Old Dominion UniversityFollow

Author ORCID Identifier

0000-0002-0302-5292 (Cipi)

DOI

10.25884/kqp9-q618

Document Type

Case Report

Subcategory

Emergency Medicine

Abstract

We report the case of a healthy 24-year-old female who presented with acute-onset left leg pain and a clinical exam consistent with phlegmasia cerulea dolens. Imaging revealed extensive occlusive thrombosis of the left common iliac vein with signs of arterial compromise. She was started emergently on intravenous anticoagulation and underwent thrombectomy with angioplasty. Intraoperative findings were consistent with May-Thurner syndrome (MTS) – compression of the left iliac vein by the right iliac artery. This syndrome leads to impaired venous return and thrombosis. The patient was discharged on oral anticoagulation with vascular follow-up for possible iliac vein stenting. Recognition of this rare syndrome is critical as management may require urgent thrombectomy and long-term vascular intervention to prevent recurrence.

Recommended Citation

Pierce E, Cipi A, Dray R. May-Thurner Syndrome as a Cause of Phlegmasia Cerulea Dolens. Eastern Virginia Medical Journal. 2026; 2(1). doi: 10.25884/kqp9-q618.