Even today, global interest among scientists regarding lymphatic system is very low. Lymphatic system is consisted of lymph vessels and lymph nodes which make a network through the entire body and it is in very close connection with circulatory system. Lymphedema has been recognized as one of the most common and most severe diseases of lymphatic system. Here some of the important issues related to lymphedema.
Role of The Lymphatic System
The lymphatic system has several roles in human body. Capillaries are permeable and they sometimes let extra fluid and proteins from the blood in tissues. Lymph vessels are responsible to pick up the excess fluid and proteins and return them to circulatory system. In other words, the most important role of lymphatic system is drainage of tissues. There is also a role in the immune system. Mediators of acquired immunity, such as lymphocytes and antibodies are generated in the lymph nodes, which are an integral part of lymphatic system. They are then distributed through the tissues by lymphatic vessels.
Causes of Lymphedema
Causes of lymphedema can be classified as primary and secondary. Primary (idiopathic) lymphedema is of an unknown origin. It is often present at birth, or it can appear in early childhood. Secondary lymphedema always appears as a result of specific cause. Various surgical procedures can damage lymph nodes and lymph vessels, thus compromising normal tissue drainage. As a consequence, fluid is accumulated in affected tissues, which causes swelling, pain, and disability. Surgical procedures to remove cancer tissue often cause lymphedema, as they require the removal of lymph nodes in order to lower the chances of cancer to give metastases. Other factors can also cause secondary lymphedema, such as lymph node injury, radiation therapy, and some medications.
Signs and Symptoms
Accumulated fluid in the tissues causes swelling and applies pressure to the surrounding structures, such as nerves, blood vessels, and other organs. Pain can appear due to stretching of nerve endings in skin, subcutaneous tissue and muscles. Lymphedema usually affects extremities, particularly their lower parts (wrists and ankles). Therefore, these joints can become painful and less mobile. Apart from lymphedema, the main disease which had caused it, additionally worsens clinical presentation carrying its own symptoms.
Diagnosis of lymphedema is made based on patient’s clinical presentation and medical history of previous surgical interventions, injuries, or exposure to radiation. No additional test are required in cases with typical presentation.
As lymph is accumulated in tissues by the law of gravity, elevation of affected extremity is helpful. Persons with leg lymphedema should wear compressive socks in order to push the fluid up away from the affected extremity. After surgical interventions, some amount of swelling appears as a reaction to tissue damage. In case that the edema persists long time after the surgery, then contact your doctor to investigate the possibility of lymphedema. Even then, the symptoms should subside and disappear within several weeks. Exercise is also recommended, but in strict agreement with your doctor. Namely, exercise does help in fluid evacuation from the limbs, but it also increases blood flow which can increase fluid accumulation. Therefore, physical activity in these patients should be moderate.
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