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The diagnosis and management of primary lymphedema.

Abstract
Although the clinical features of lymphedema are often distinctive, it is essential to confirm the diagnosis with an objective test. Isotope lymphography is simple and 95% accurate for defining deficient lymph clearance. It is particularly useful for separating venous from lymphatic edema. Definition of the precise abnormality--peripheral lymphatic obliteration, proximal lymph node obstruction, or valvular incompetence--can only be made with lymphangiography. The mainstay of treatment is the reduction of edema by regular elevation and massage and external compression with elastic stockings. Pneumatic leggings are also helpful. Gross edema caused by peripheral obliteration may be reduced surgically by simple excision (Homans' operation) or complete excision and skin grafting (Charles' operation). Reflux through incompetent vessels may be prevented by vessel ligation. Obstruction by the iliac lymph nodes may be bypassed with an enteromesenteric pedicle.
AuthorsN L Browse
JournalJournal of vascular surgery (J Vasc Surg) Vol. 3 Issue 1 Pg. 181-4 (Jan 1986) ISSN: 0741-5214 [Print] United States
PMID3510325 (Publication Type: Journal Article)
Chemical References
  • Colloids
  • technetium Tc rhenium-sulfur colloid
  • Technetium Tc 99m Sulfur Colloid
  • Rhenium
Topics
  • Clothing
  • Colloids
  • Female
  • Humans
  • Leg (diagnostic imaging)
  • Lymphedema (diagnosis, surgery, therapy)
  • Lymphography
  • Male
  • Massage
  • Radionuclide Imaging
  • Rhenium
  • Skin Transplantation
  • Technetium Tc 99m Sulfur Colloid

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