Recurrent lymphangitis, deep trauma, malignancy, and related treatments (ie surgery
and radiotherapy) are usually considered the commonest causes of lymphedema. The role
of chronic venous disease in this context is often overlooked; yet, all patients with
advanced venous disease (stasis dermatitis) have some degree of lymph circulation
impairment.
1.
Venous edema is assumed to be the sole consequence of increased capillary filtration
from venous hypertension. Because lymph drainage is the main buffer against the formation
of edema, a compensation for the increased lymph load does occur at the beginning.
In the long run, however, when the transport capacity is exceeded, the lymphatics
fail to keep their buffer function, and interstitial fluid accumulates. This leads
to a clinical condition of mixed venous and lymphatic insufficiency that causes a
progressive swelling of soft tissues, which is termed phlebolymphedema.
2.
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© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
