Swelling of lymph on the legs
Lymphostasis is a violation of lymph drainage in the legs,hands, other parts of the body. The disease can be both congenital and acquired. As a result of a malfunction during the outflow of lymphatic fluid, it accumulates in the tissues, limbs, which leads to their swelling.
Other names for lymphostasis of the extremities -lymphatic swelling of the legs or lymphadenemia. According to statistics, this disease affects about 10% of the world's population. As progression progresses, pathology can lead to the development of elephantiasis and cause not only psychological and physical suffering, but also disability.
Lymphostasis develops due to a number offactors. Lymph outflow can be disrupted as a result of heart failure, kidney pathologies, hypoproteinemia. These diseases lead to the fact that the lymphatic vessels can not cope with the outflow of the lymphatic fluid, which leads to its retention in the tissues.
- The lymph is delayed in the limbs andchronic venous insufficiency, characteristic of decompensated forms of varicose veins. arteriovenous fistula and postthrombophlebitic syndrome. The result of removing a large amount of fluid is compensatory expansion of the vessels of the lymphatic system, which leads to a decrease in their tone, poor valve performance and lymphovenous insufficiency.
- Lymphostasis can be the result of vicesthe lymphatic system itself, impaired patency of some lymphatic vessels, which occurs due to their mechanical damage (during surgery, burns, etc.), squeezing a tumor or infiltrates of the inflammatory process, preventing the outflow of lymph.
- Obliteration of some lymphatic vessels with lymphangitis or lymphadenitis causes them to expand and disrupt the normal operation of the valves of other vessels, which leads to a lymphatic stasis.
- Conducted for a breast tumorExtended mastectomy in some cases may also be complicated by the appearance of limfodemia of the extremities. As a rule, under mastectomy, axillary lymphadenectomy (axillary lymphadenectomy) is performed, the essence of which is the removal of lymph nodes, which are subject to regional metastasis. The degree of likelihood of lymphostasis is directly dependent on the volume of lymphadenectomy.
- Lymphostasis can result from lymphoma, prostate cancer, radiotherapy in areas of regional lymph drainage, removal of inguinal and hip lymph nodes.
- The cause of impaired lymph flow is sometimes streptococcal lymphangitis of a recurrent nature (with a face or phlegmon) or parasitic infections.
- In the tropical region may occurspread by mosquitoes lymphatic filariasis (elephantiasis, elephantism), in which lymph nodes are affected and enlarged, fever develops, patients suffer from severe pain, their hands, legs, chest and genitals are hypertrophied.
In connection with the causes of development of lymphostasis is divided into the following types:
Primary is a consequence of congenital diseasesor deficiencies in the functioning of the lymphatic system. Pathology manifests itself immediately after the birth of the baby or at an intermediate age, at the stage of puberty.
The secondary type develops as a result of several factors:
- sedentary lifestyle (especially for bedridden patients);
- presence of tumors of the lymphatic system;
- injuries that put pressure on the vessels;
- chronic diseases, leading to violation of venous circulation in the limbs;
- diseases of infectious etiology, provoking disruption of the work of the body's basic systems;
- excess weight;
- surgical intervention.
Stages and symptoms of the disease
In its development, pathology passes through three main stages.
- The first (mild) is characterized by the presence of systematicpassing insignificant edema closer to the evening hours, which practically disappear by morning or after rest. Edema increases as a result of intense physical exertion or prolonged stay in motion. Load on the legs also helps to delay lymph. At this stage there are no proliferation and changes in connective tissue. The help of a specialist, which consists in conservative methods of treatment, in most cases gives an excellent result in the form of a persistent regress of the pathological process.
- For second stage (average severity) is characterized by the presencenon-vanishing edema that persist after a night's rest, proliferation of connective tissue, skin tightness, tightening, the appearance of pain syndrome. When you press your finger in the area of the swelling, there are long-lasting traces. Stagnation of lymph becomes the cause of seizures and fast fatigue of the affected limb.
- On third stage (severe form) of lymph flow disturbancethey become irreversible, fibrocystic changes take place in affected tissues, elephantia develops. Lymph stagnation is so significant that the affected limb can not function properly and loses its contours and proportions. At this stage, often accompanying diseases: deforming osteoarthritis, contractures, eczema, trophic ulcers, erysipelatous inflammation. In very serious cases, a lethal outcome is possible as a result of sepsis. The third stage of lymphostasis can lead to the development of lymphosarcoma.
Common symptoms of lymphostasis are:
- general weakness;
- presence of a white coating on the tongue;
- inability to concentrate attention;
- the appearance of excess weight;
- joint pain.
In the presence of characteristic symptoms for clarificationdiagnosis can be assigned to ultrasound examination of the veins of the lower limb, as well as examination of the abdominal and pelvic organs to identify certain changes and diseases that promote the development of lymphostasis.
- general analysis of blood and urine;
- X-ray lymphography.
The goal of the last two studies isthe determination of the patency of the vessels and the specific location of the lymphatic block. They make it possible to detect changes in lymphatic vessels, zones of crimp, valvular insufficiency, and lymphangiectasia.
Differential diagnostics withdeep vein thrombosis and post-phlebitis syndrome, characterized by unilateral lymphedema, soft edema, hyperpigmentation, varicose veins and eczema. The ultrasound of the veins is prescribed to exclude the pathology of the veins.
If necessary, an additional examination of other systems and organs is prescribed to reduce the risk of recurrence of the disease.
Treatment of lymphostasis consists in measures to restore lymph drainage from the affected limbs or organs.
Most often, the following procedures are prescribed for this purpose:
- manual lymph drainage massage;
- laser therapy;
- hardware pneumocompression;
- wearing compression linen.
- compliance with a special diet with low or salt content;
- daily execution of a complex of therapeutic exercises;
- Scandinavian walking;
Medicamentous treatment consists in the use of the following drugs:
- phlebotonics with lymphotropic action;
If eczema and trophic ulcers develop, they also undergo treatment.
If you have a diagnosis of "lower limb lymphostasis," you should carefully monitor the condition of the feet, take care of them to prevent lymphangitis.
To do this, it is recommended to carry out medical hardware pedicure with the use of special hygiene and care products.
In the presence of infection of fungal etiology, antimycotic drugs of both general and local action are used.
In the case of a complex of conservativemethods of treatment, further progression of the disease, severe fibrosis and the presence of deforming lymphatic sac are prescribed surgical intervention. Its essence lies in the microsurgical creation of lymphovenous anastomoses, dermatophasiolipectomy and liposuction.
With lymphoedema of the primary type, a complete lymphoid tissue complex is transplanted.
Expressive elephantism excludes carrying outradical operations and is an indication for the tunneling of affected areas with the purpose of removing lymph in healthy tissues. Resection interventions can also be used.
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