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Lymphoedema

Obstruction of the lymphatics resulting in swelling due to accumulation of interstitial fluid is known as Lymphoedema. It is a very troubling and disturbing condition and can lead to many complications. If the problem is in the Legs ....

Lymphoedema

What is Lymphoedema?

Obstruction of the lymphatics resulting in swelling due to accumulation of interstitial fluid is known as Lymphoedema. The condition is of two types - primary and secondary

What is Primary Lymphoedema?

Primary lymphoedema is due to congenital maldevelopment of the lymphatic trunks and particularly affects the lower limb. The condition is of insidious onset and occors more commonly in women, often commencing at puberty.

What are the symptoms of Primary Lymphoedema?

  • The distal part of the leg is first affected and initially may be temporarily relieved by alevation.
  • In the later stages the whole limb becomes grossly oedematous.
  • Discomfort from heaviness and an unsightly appearance are the main complaints.

What is the treatment?

  • The most important aspect is to keep the oedema under control and every text book suggests a regular usage of Graduated Compression Stockings.
  • At night the leg should be elevated by 30 cms.
  • Application of compression with the help of Intermittent Pneumatic Compression Pump may bring down the oedema but usage of Graduated Compression Stockings. for maintaining the achieved reduction is a must.
  • A course of diuretics and/or surgery as suggested by the treated surgeon.

What is Secondary Lymphoedema / Filarial Lymphoedema?

  • It is the result of inflammatory involvement of lymphatics or nodes. It may also occur after surgical extirpation in block dissection of axilla or groin or treatment with radiotherapy.
  • Filarial Lymphoedema is due to presence of filaria in lymphatics.

What are the symptoms?

  • The symptoms are almost the same as that of primary lymphoedema but they appear more rapidly.
  • Filarial Lymphoedema may be associated with recurrent infection in the skin.
  • Periodic bouts of high fever and marked redness of the affected leg are classical symptoms.

What is the treatment?

  • The most important thing is to take care of the Oedema (swelling). Elevation of limb during night, application of Graduated Compression and C.P.T.(Complex Physical Therapy) can take care of this problem.
  • For old and stubborn oedema application of compression with the help of an Intermittent Pneumatic Compression Pump may be needed. Graduated Compression Stockings. must be used for maintaining the reduction achieved by using the pump.
  • Certain antibiotics and other drugs may be needed which the doctor can prescribe after examining the patient.

If left untreated?

  • If left untreated lymphoedema keeps worsening. If it increases rapidly it causes great pain because tissues are being torn apart.
  • Over a period of time it can decrease mobility of the joints and make them painful.
  • Slowly and gradually the texture of the skin also starts changing and it becomes rough and stony.
  • Overall it causes a general worsening of the patient's life and health, causes embarassment and can also lead to depression.

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