LYMPHOEDEMA

Lymphoedema

• Definition: Lymphoedema is a chronic swelling condition that occurs when the lymphatic system is unable to drain fluid properly from the body, leading to accumulation of protein-rich fluid in the interstitial tissue.

• Aetiology: Lymphoedema can be caused by various factors such as:

  • Congenital lymphoedema
  • Trauma or injury
  • Infection or inflammation
  • Cancer or radiation therapy
  • Surgery or lymph node removal
  • Inherited conditions such as lymphoedema-distichiasis syndrome

• Types of Lymphoedema:

  • Primary lymphoedema: This is a rare condition that occurs due to a defect in the lymphatic system.
  • Secondary lymphoedema: This occurs due to a secondary cause such as trauma, infection, or cancer.
  • Lymphoedema praecox: A type of primary lymphoedema that affects the limbs.
  • Lymphoedema tarda: A type of primary lymphoedema that affects the limbs and usually develops in adulthood.
  • Lymphoedema congenitale: A rare type of primary lymphoedema that affects the limbs.

• Pathology: Lymphoedema occurs due to the impairment of lymphatic drainage, which leads to accumulation of fluid in the interstitial tissue. The fluid becomes protein-rich and leads to inflammation and scarring.

• Clinical signs and symptoms:

  • Swelling of the affected limb
  • Pitting or non-pitting edema
  • Skin thickening and fibrosis
  • Reduced mobility and pain
  • Infection and skin breakdown

• Physical examination of the lymphatic system:

  • Inspection of the affected limb for swelling and skin changes
  • Palpation of the affected limb for tenderness and skin thickening
  • Assessment of lymph node function
  • Assessment of blood flow and circulation

Investigations

• USG (Ultrasound): To assess lymph node function and fluid accumulation in the interstitial tissue.
• CT (Computed Tomography) scan: To assess lymph node function and fluid accumulation in the interstitial tissue.
• MRI (Magnetic Resonance Imaging) scan: To assess lymph node function and fluid accumulation in the interstitial tissue.
• Lymphangiography: To assess lymphatic function and identify any blockages or damage.

Management

• Conservative management:
  • Compression garments and bandages
  • Exercise and physical therapy
  • Weight management
  • Skin care and wound management
• Surgical management:
  • Lymph node transfer or implantation
  • Lymphaticovenous anastomosis
  • Lymph node removal and debridement
• Alternative therapies:
  • Manual lymphatic drainage
  • Aerotherapy
  • Lymphatic massage

Homoeopathic Therapeutic Medicines

• Arsenic album - For swelling and pain
• Calcarea - For skin thickening and fibrosis
• Graphites - For skin thickening and fibrosis
• Hydrastis - For skin thickening and fibrosis
• Nux vomica - For swelling and pain
• Sulphur - For skin thickening and fibrosis
• Thuja occidentalis - For skin thickening and fibrosis
• Urtica urens - For skin thickening and fibrosis