Swelling of the legs: what happened to the lymphatic system?

Increasing swelling of the soft tissues of the legs can be caused by lymphedema – a pathological condition in which the outflow of fluid through the lymphatic vessels is disturbed. Lymphedema is very widespread, in the world almost every tenth person has swelling of the legs associated with the pathology of the lymphatic vessels. This pathology can be congenital and acquired, appear immediately after the disease or injury that provoked it, and can be diagnosed ten or more years later. In the later stages, lymphedema can cause purulent processes in the skin  and lymphangiosarcoma.  But at the beginning of the disease, with timely treatment, & nbsp; its development can be stopped.

 Causes of lymphedema and types of disease

Swelling of the legs with lymphedema develops due to a violation of the movement of fluid through the lymphatic vessels. Lymph drainage can also be disturbed in the upper extremities, but most often soft tissue edema occurs in the legs. The cause of lymphedema is usually a hereditary pathology of the walls of the lymphatic vessels – when they do not have the proper tone, when there is hypoplasia or even aplasia of the lymphatic vessels. Sometimes lymphedema develops due to damage to the lymph nodes after injuries or certain diseases.

Acquired causes of lymphedema

When taking a history of a patient with suspected lymphedema, it should be taken into account that this condition of leg edema may develop 10 years or more after external exposure that damaged the lymph nodes. Acquired lymphedema can be caused by:

• infectious disease;
• burns;
• injuries, including surgical interventions, when the lymph nodes were affected, or they were removed;
• irradiation.
• Hereditary lymphedema may first appear during pregnancy or after an injury. Secondary lymphedema is aggravated if combined with venous insufficiency.

 The main symptoms of lymphedema and possible complications

Swelling of the legs, characteristic of lymphedema, does not appear immediately. Initially, the patient complains of a feeling of fullness in the legs, heaviness, pain. The condition may be accompanied by general weakness and limitation of the joints. Later, swelling appears, the skin turns pale, the saphenous veins are not visible.

If the lymphedema is congenital, then the swelling of the legs starts from the foot. The toes swell tightly, swelling gradually spreads to the ankle joint and above. Later, the legs begin to resemble columns. With secondary lymphedema, the proximal part of the limb swells first just below the femoral lymph nodes, and then the edema covers the entire leg to the foot.

Swelling of the legs can affect both limbs, and one of them. Due to swelling, tissue nutrition is disrupted and hyperkeratosis develops – the skin begins to crack, ulcerate, fistulas may develop.

Lymphedema can be complicated by the addition of an infection, which causes erysipelas and phlegmon. As a result, even intact lymphatic vessels are damaged and the disease progresses rapidly, sometimes to a malignant tumor.

 Treatment of lymphedema and measures to prevent swelling of the legs

Therapy for lymphedema depends on the stage of the disease. If there are no organic changes in the soft tissues, the development of the disease can be slowed down, stopped and even reversed with the help of a special diet, physiotherapy exercises, massages, hardware and physiotherapy procedures.

Surgical treatment of lymphedema involves the creation of bypasses for lymph drainage. In the region of the popliteal fossa, lymphatic vessels are isolated, crossed, the central ends are coagulated, and the peripheral ones are connected to the saphenous veins. In the early stages, such an operation completely restores the movement of fluid through the lymphatic vessels and prevents swelling of the legs.

Patients with early manifestations of lymphedema or at increased risk of developing it should be advised to ensure that the lymph flow is not obstructed and that there is no risk of infection: do not cross your legs when sitting, do not walk barefoot, keep your feet clean at the first manifestations swelling of the legs consult a doctor.