LYMPHOSTASIS

From Big Medical Encyclopedia

LYMPHOSTASIS (Latin lympha pure water, moisture + grech, stasis standing; synonym: lymphatic hypostasis, limfedem) — accumulation of a lymph in intersticial fabric and complete cessation of its current with formation of a proteinaceous coagulate in limf, ways. L. can be primary and secondary. Primary L. it is observed at an inborn dysplasia limf, vessels, secondary — at obstruction limf, ways as a result of the mechanical obstacle to current of a lymph arising owing to blockade limf, vessels, nodes, channels after inflammatory processes, injuries, operative measures, at a prelum by hems, a tumor, at an embolism complexes of tumor cells or parasites (filarias), and also at funkts, insufficiency limf, vessels, arising owing to a spasm, the increased venous pressure (at arteriovenous fistulas, hron, venous insufficiency).

At emergence of an obstacle the lymph slows down the current, limf, vessels extend; considerable frustration of a lymph drainage, switching off of extensive network limf, ways or an obstacle to current of a lymph in the main limf, channels can bring to L. Redko the L is observed. in skin since in it from limf, capillaries form lymphangiectasias (see), followed lymphorrhea (see); at the same time hypertrophic changes of skin usually do not occur also L. seldom reaches the big sizes.

Microscopically at L. sharp expansion of gleams limf, vessels with side protrusions of their walls is observed. On certain sites treatment by a lymph and swelling of connective tissue elements of a wall limf, vessels as plasmatic treatment is noted; formation of intraparietal cavities is noted. In the outcome of L. there comes retraction of a proteinaceous coagulate and its organization with full obturation of a gleam limf, a vessel.

L. develops preferential on the lower extremities, is more rare on external genitals, upper extremities, the person. Hypostasis at L. the lower extremities it is localized usually on the back of foot or in the lower third of a shin, has non-constant character: increases in warm season, after physical. loadings also decreases (up to total disappearance) during the autumn and winter period, after long rest. At a size of hypostasis at L. the slow-moving way of life, the work connected with long stay standing, a nerve strain, etc. influences. The integument has usual coloring, the drawing of network of saphenas is expressed indistinctly; hypostasis is soft, painless, the skin fold is thickened, but is mobile. Tendency to inflammatory processes on the affected extremity is noted, to-rye much worsen the course of a disease, promote its progressing.

For diagnosis of L. methods lympho-and venografiya, radio isotope researches are used. At primary forms of H.p. the help limfografiya (see) depletion limf, the vascular drawing is found, at secondary — considerable expansion limf, vessels, their crimpiness, lymphangiectasias with signs of valve insufficiency. At a radio isotope research by means of albumine, marked 131 I, the elimination half-life of isotope averages 229,9 min. and decreases after an exercise stress up to 64,5 min., unlike elephantiasis, at a cut there is an increase in an elimination half-life up to 299,9 min. The differential diagnosis is carried out with the hypostases connected with defeats of cardiovascular system, diseases of kidneys, etc. Treatment is operational, it is directed to recovery of a lymph drainage by imposing of a direct limfovenozny anastomosis and creation indirect limf, messages by means of a fasciotomy. In quality of training to operation the conservative symptomatic treatment is carried out. Sometimes at L. operational treatment is carried out for the purpose of removal of edematous fabrics. The forecast for life favorable.



Bibliography: Zerbino D. D. General pathology of lymphatic system, Kiev, 1974; Brunner U. Zur Friihdiagnose des primaren Lymphodems des Beine, Vasa, Bd 1, S. 29*3, 1972; O o m e n A. P. A reconsideration of the problem of elephantiasis, Trop. geogr. Med., y. 21, p. 225, 1969, bibliogr.


D. D. Zerbino, T. V. Savchenko.

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