Introduction: Phlegmasia cerulea dolens (PCD) is a rare pathology with a very high morbidity and mortality rate, which usually occurs in the lower limb. There is very little literature available to aid management.
Case report: We present a case of upper limb PCD in a 67-year-old female secondary to heparin-induced thrombocytopenia caused by warfarin bridging. She presented to the orthopedic team with upper limb compartment syndrome from a bleed around a peripherally inserted central catheter, for which she was urgently taken to the theater for fasciotomies. Postoperatively, the patient's platelets dropped and the upper limb pain and swelling continued; after conservative management and anticoagulation failed the patient had an upper limb amputation of her right arm.
Conclusion: With limited guidelines and management options restricted by the large fasciotomy wounds, we believe amputation was the patients' best option.
Keywords: Amputation; Compartment Syndrome; Deep vein thrombosis; Haematology; Heparin Induced Thrombocytopenia; Orthopaedic; Phlegmasia Cerulea Dolens; Vascular.