Six patients who developed phlegmasia cerulea dolens are described. All pa tients had associated hypercoagulable states: heparin-induced thrombocytope nia (2 patients), congenital deficiency of protein C (1 patient), and antithrombin III deficiency (3 patients). Their clinical course and management are discussed. Previous reports have failed to show a definite correlation between phlegmasia cerulea dolens and hypercoagulable states because of an unavailability of appro priate diagnostic techniques. Phlegmasia cerulea dolens is a life- and limb- threatening complication. An appreciation of underlying hypercoagulable states is essential to proper management, prophylaxis, and treatment of this disorder.
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