Lümfedeemides

Lümfedeemides is a medical condition characterized by swelling caused by dysfunction or obstruction of the lymphatic system. In medical terminology it is most commonly referred to as lymphedema. The condition can be divided into primary forms, due to congenital lymphatic abnormalities, and secondary forms, arising after injury to or treatment of the lymphatic system.

Pathophysiology: Impaired lymphatic drainage leads to persistent accumulation of protein-rich fluid in the interstitial space. Over time, tissue fibrosis and fat deposition may occur, increasing risk of infection and skin changes.

Clinical features: The affected limb or area swells gradually and may be asymmetric. Early stages show pitting edema that improves with elevation; later stages show non-pitting, thickened skin and reduced elasticity. Patients may experience heaviness, tightness, and limited range of motion. Recurrent cellulitis is a common complication.

Causes and risk factors: Primary lymphedema arises from genetic or developmental lymphatic abnormalities. Secondary lymphedema results from cancer treatment (lymph node dissection or radiation), vascular or infectious diseases (eg, filariasis), trauma, obesity, or venous insufficiency.

Diagnosis: Diagnosis relies on clinical evaluation supported by imaging and measurement. Lymphoscintigraphy and indocyanine green lymphography visualize lymphatic flow; ultrasound helps assess venous disease; limb volume measurements track progression.

Management: The cornerstone is decongestive therapy, including compression garments, manual lymph drainage, and exercise. Skin care and prompt treatment of infections are important. Weight loss may help when obesity is a factor. In refractory cases or for patients seeking definitive treatment, surgical options such as lymphovenous bypass or vascularized lymph node transfer may be considered.

Prognosis and epidemiology: Lymphedema is usually a chronic condition that can be managed but not cured. Incidence is higher after cancer treatment and in tropical regions with filariasis; it is more commonly diagnosed in adults and tends to affect women more often in some populations.