Natural Treatment for Lymphedema Found

ABC of arterial and venous disease Swollen lower limb2 Lymphoedema

Lymph conducting pathways may become reduced in number, obliterated, obstructed, or dysfunctional (because of failure of contractility or valve incompetence). A lack of sensitive methods for investigation makes it difficult to distinguish between these mechanisms. A defect in the lymph conducting pathways leads to primary lymphoedema in practice this means no identifiable outside cause can be found. Secondary lymphoedema is due to factors originating outside the lymphatic system. Primary lymphoedema Congenital lymphoedema presenting at or soon after birth is rare. A family history suggests Milroy's disease. Swelling invariably affects both lower limbs, but the upper limbs and face may also swell. Most forms of primary lymphoedema present after puberty with foot and ankle swelling. Women are more often affected, and the condition may be familial for example, Meige's disease. Lymph reflux due to lymphatic vessel hypertrophy or megalymphatics is clinically distinguishable. Secondary...

Lymph drainage in carcinoma of the breast

The axillary lymph nodes represent an early site of metastasis from primary breast malignancies and their surgical removal and subsequent examination provide important prognostic information as well as a basis for choice of adjuvant treatment. Damage to axillary lymphatics during surgical clearance of axillary nodes or resulting from radiotherapy to the axilla increases the likelihood of subsequent upper limb lymphoedema.

Clinical evidence of lymphadenopathy

If the groin nodes are grossly enlarged and either fixed or ulcerated, histological confirmation of the diagnosis is advisable. Surgical excision should be considered for all macroscopic enlarged nodes in the groin and enlarged nodes seen on CT prior to radiotherapy. A full inguinofemoral lymphadenectomy should be avoided in order to avoid severe lymphoedema. If the nodes are deemed not resectable, pre-operative radiotherapy with or without chemotherapy is advised. This should then be followed by post-operative resection of macroscopic residual disease.

Invasive Therapy Surgery

Surgical therapy is the principal modality used for treatment of rectal cancer with curative intent. Yet it is only one of many modalities used in palliative therapy. Although many options are available for the palliation of cancer of the intra-abdominal colon, such as abdominal colectomy, segmental resection, internal bypass, or fecal diversions, surgical palliation of rectal cancer is technically more difficult and options are more limited. This is due to the anatomic restrictions of the pelvis and the fact that there is more commonly fixation of the tumor to major structures like the iliac vessels, prostate, bladder, or nerve roots. Operative palliative therapy is indicated in patients that are able to tolerate surgery and with the intent of providing relief or improvement of symptoms while maintaining normal function. Indications include bowel obstruction, perforation of the rectum, formation of rectal fistulas to the vagina, bladder or prostate, bleeding, pain, and local...

Management of the Axilla

In the presence of axillary disease, an axillary dissection is an excellent operation for regional control and prognostic information. However, for the great majority of patients with early breast cancer, an axillary dissection does not confer any therapeutic benefit. The greatest concern, particularly for younger, active patients is the risk of developing lymphedema. This risk is directly related to the extent of the axillary dissection and is further increased with the addition of radiation therapy.53 This risk remains indefinitely for the life of the patient. Other potential side effects include paresthe-sias, loss of mobility, and cosmetic deformity.

Cutis Marmorata Telangiectatica Congenita

Lymphedema in an infant with Turner's syndrome shows pitting edema on die dorsum of the hand. The diffuse soft tissue swelling in lymphedema is caused by increased accumulation of lymph due to inadequate lymphatic drainage. Lymphedema may be primary (congenital) or secondary.

Colon Varices and Portal Colopathy

Sigmoid Colon

Sharp increases in portal hypertension related to liver cirrhosis or portal vein thrombosis can cause formation of varices throughout the entire colon (Fig. 17.12). Lymphedema is not present. Bleeding is acute and can be controlled with fibrin glue and hemoclips. Long-term prophylactic measures such as lowering

Radiotherapy Complications

Other reported complications from breast radiation include lymphedema, rib fracture, brachial plexopathy, pulmonary fibrosis, carcinogenesis, and contralateral breast cancer. Standard surgical therapy for invasive breast cancer includes level I and II axillary dissection, which has a finite risk of arm edema of 10 to 15 percent.129,130 The addition of radiotherapy may increase the risk to as high as 20 percent. The measured incidence of arm edema likely differs from the incidence of clinically significant arm edema. One study showed a direct relationship between the incidence of arm edema and the number of lymph nodes dissected.131 There is less risk of lymphedema in a level I and level II selective dissection than in a full axillary dissection. It is hoped that sentinel node biopsy will eliminate this complication for patients with histologically negative nodes. Any risk of lymphedema after sentinel node biopsy has yet to be determined. Brachial plexopathy is a complication in...

Swollen lower limb1 General assessment and deep vein thrombosis

The most common cause of leg swelling is oedema, but expansion of all or part of a limb may be due to an increase in any tissue component (muscle, fat, blood, etc). A correct diagnosis requires consideration of whether the swelling is acute or chronic, symmetrical or asymmetrical, localised or generalised, and congenital or acquired. Chronic swelling, particularly if asymmetrical, is usually a sign of chronic oedema arising from venous or lymphatic disease, whereas symmetrical lower limb swelling suggests a systemic or more central cause of oedema, such as heart failure or nephrotic syndrome. Oedema develops when the rate of capillary filtration (lymph formation) exceeds lymphatic drainage, either because of increased capillary filtration, inadequate lymphatic flow, or both. Extracellular fluid volume is controlled prinicpally by the lymphatic system, which normally compensates for increases in capillary filtration. Most oedemas arise because filtration overwhelms the lymph drainage...

Yellow Nail Syndrome

Yellow nail syndrome is an uncommon disorder of unknown aetiology, characterized by the triad of yellow nails, lymphoedema and respiratory tract involvement. Vitamin E at dosages ranging from 600 to 1200 IU daily can induce a complete clearing of the nail changes. Although the mechanism of action of vitamin E in yellow nail syndrome is still unknown, antioxidant properties of alpha-tocopherol may account for its efficacy. A 5 solution of vitamin E in dimethyl sulphoxide produced marked clinical improvement in a double-blind controlled study. The efficacy of topical vitamin E, however, still needs confirmation. Oral itraconazole, 400 mg daily one week a month for several months, or oral flucouazole, may be beneficial in some cases.

Turner Syndrome

Turner Syndrome

Infants with Turner's syndrome (XO syndrome) are phenotypically female although they have one of the pairs of X chromosomes missing. This term infant is short (length 43 cm) and demonstrates the short neck, shield-like chest with widely spaced nipples, and lymphedema, especially of the feet. Note also the single palmar crease on the right hand. Infants with Turner's syndrome may be small for gestational age.