Abstract
Phlegmasia cerulea dolens (PCD) is a rare condition that poses significant challenges due to its high mortality and morbidity rate and lack of formal, well-developed treatment protocols. PCD presents as a massive deep vein thrombosis associated with compartment syndrome of the lower extremities. This case report outlines the clinical course of a 64-year-old morbidly obese female patient with a history of hypertension, dyslipidemia, hypothyroidism, and pulmonary embolism who presented to the emergency department with PCD. Despite thrombolytic therapy, oral anticoagulation, and endovenous thrombectomy, the patient's condition only worsened, resulting in refractory shock and death. This case highlights the significance of recognizing PCD early, anticipating its complications, and refining management strategies to improve patient outcomes.