LYMPHORRHEA

From Big Medical Encyclopedia

LYMPHORRHEA (lymphorrhea; lat. lympha pure water, moisture + grech, rhoe current; synonym limforragiya) — the expiration of a lymph from absorbent vessels owing to their damage or a disease.

The most frequent reasons L. the opened and closed damages large are absorbent vessels (see), especially chest channel (see), operative measures in the areas rich limf, vessels, napr, a mastectomy; also spontaneous gaps expanded, patholologically changed limf, vessels are possible at to a lymphangioma (see), lymphangiectasias (see) that is usually connected with existence of accruing lymphostasis (see), especially in its combination with limfangiity (see) that is promoted by bruises of fabrics (raschesa, attritions etc.).

At the opened and closed damages of a chest channel, depending on the level of damage, the lymph can accumulate in a chest cavity (see. Chylous hydrothorax ), in a pericardiac cavity (see. Pericardis ) or in a cavity of a stomach (see. Peritonitis ). At the closed damages peripheral limf, vessels the lymph can fill intermuscular cracks or impregnate surrounding fabrics.

A clinical picture

At the open damages, depending on caliber damaged limf. vessels, the lymph exudes from a wound, is allocated with drops, follows a stream. In the beginning it is colourless or pink color from impurity of blood, then as a result of infection can become muddy. L. can proceed from several hours to several days, bringing in hard cases to extreme exhaustion of patients owing to loss of a large amount of water, proteins, fats, electrolytes and other vital substances.

The condition of the patient considerably worsens at accumulation of a lymph in serous cavities that leads to development of chyle inflammatory process in the affected cavity.

Diagnosis at open damages limf, vessels put on the basis of the outside expiration of a lymph. At the closed damages for diagnosis of L. existence of fractures of chest vertebras or edges with injury of a pleura at simultaneous presence at a cavity of free liquid matters, edges the wedge, and rentgenol, methods of a research decides on the help.

Besides, L. it is possible to define by a puncture of a cavity and places of possible accumulation of a lymph. For definition of the place of damage limf, a vessel resort to limfografiya (see). For detection of the place of damage limf, a vessel during operation the patient is previously given the colorants painting a lymph (Evans's paint, methylene blue, etc.). B. V. Ognev, etc. offered in 1,5 — 2 hours prior to operation to feed the patient with fat mixes.

Treatment

Stop the expiration of a lymph by imposing of a compressing bandage, a tamponade of a wound. At inefficiency of conservative actions make surgery — imposing of the cutting-away seams, bandaging limf, a vessel or recovery of its passability (imposing of a limfovenozny anastomosis, etc.). At the same time carry out the general treatment directed to completion of loss of proteins, waters, electrolytes on the prevention and fight against an infection, etc.

The forecast at long and plentiful L. adverse. Bandaging damaged limf, a vessel at any level or successfully performed recovery operation cure the patient.


Bibliography: Ibatullin I. A. Etiology and pathogeny of limfoistecheniye, Surgery, No. 5, page 130, 1977; X r about m about in B. M. Hirurgiya of lymphatic system, in the same place, No. 1, page 122, 1973, bibliogr.


A.S. Yakovlev.

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