Gangrene of Lower Extremity Secondary to Extensive Venous Occlusion

G ANGRENE of an extremity caused by venous occlusion without associated arterial occlusion is uncommon. Haimovicil noted that Fabricus Hildanus, in 1593, apparently recognized the possibility of gangrene of ve- nous origin; it was not until 1859, however, that Heuter2 reported a case, giving an excellent account of the clinical and pathologic criteria of this type of gangrene. Gregoire,3 in 1938, coined the term "phlegmasia cerulea dolens" to denote extensive venous occlusion that is characterized by cyanosis, ischemia, woody edema, violaceous discoloration, ecehy- mosis, and transient loss or reduction of arte- rial pulsations. Like Tremolieres and Wran,4 who described this condition in 1929, Gregoire attributed the ischemia to secondary arterio- spasm.