Differential diagnosis, investigation, and current treatment of lower limb lymphedema
Identifieur interne : 000684 ( PascalFrancis/Checkpoint ); précédent : 000683; suivant : 000685Differential diagnosis, investigation, and current treatment of lower limb lymphedema
Auteurs : Alok Tiwari [Royaume-Uni] ; Koon-Sung Cheng [Royaume-Uni] ; Matthew Button [Royaume-Uni] ; Fiona Myint [Royaume-Uni] ; George Hamilton [Royaume-Uni]Source :
- Archives of surgery : (Chicago, IL. 1960) [ 0004-0010 ] ; 2003.
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- Pascal (Inist)
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- topic : Homme.
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Abstract
Hypothesis: The causes and management of lower limb lymphedema in the Western population are different from those in the developing world. Objective: To look at the differential diagnosis, methods of investigation, and available treatments for lower limb lymphedema in the West. Data Source: A PubMed search was conducted for the years 1980-2002 with the keyword "lymphedema." English language and human subject abstracts only were analyzed, and only those articles dealing with lower limb lymphedema were further reviewed. Other articles were extracted from cross-referencing. Results: Four hundred twenty-five review articles pertaining to lymphedema were initially examined. This review summarizes the findings of relevant articles along with our own practice regarding the management of lymphedema. Conclusions: The common differential diagnosis in Western patients with lower limb swelling is secondary lymphedema, venous disease, lipedema, and adverse reaction to ipsilateral limb surgery. Lymphedema can be confirmed by a lymphoscintigram, computed tomography, magnetic resonance imaging, or ultrasound. The lymphatic anatomy is demonstrated with lymphoscintigraphy, which is particularly indicated if surgical intervention is being considered. The treatment of choice for lymphedema is multidisciplinary. In the first instance, combined physical therapy should be commenced (complete decongestive therapy), with surgery reserved for a small number of cases.
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Hospital National Health Service (NHS) Trust</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Button, Matthew" sort="Button, Matthew" uniqKey="Button M" first="Matthew" last="Button">Matthew Button</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>University Department of Surgery, Royal Free Hospital National Health Service (NHS) Trust</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Myint, Fiona" sort="Myint, Fiona" uniqKey="Myint F" first="Fiona" last="Myint">Fiona Myint</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>University Department of Surgery, Royal Free Hospital National Health Service (NHS) Trust</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>North Middlesex University Hospital NHS Trust</s1><s2>London</s2><s3>GBR</s3><sZ>4 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Hamilton, George" sort="Hamilton, George" uniqKey="Hamilton G" first="George" last="Hamilton">George Hamilton</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>University Department of Surgery, Royal Free Hospital National Health Service (NHS) Trust</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">03-0179722</idno><date when="2003">2003</date><idno type="stanalyst">PASCAL 03-0179722 INIST</idno><idno type="RBID">Pascal:03-0179722</idno><idno type="wicri:Area/PascalFrancis/Corpus">000701</idno><idno 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sortKey="Cheng, Koon Sung" sort="Cheng, Koon Sung" uniqKey="Cheng K" first="Koon-Sung" last="Cheng">Koon-Sung Cheng</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>University Department of Surgery, Royal Free Hospital National Health Service (NHS) Trust</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Button, Matthew" sort="Button, Matthew" uniqKey="Button M" first="Matthew" last="Button">Matthew Button</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>University Department of Surgery, Royal Free Hospital National Health Service (NHS) Trust</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Myint, Fiona" sort="Myint, Fiona" uniqKey="Myint F" first="Fiona" last="Myint">Fiona Myint</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>University Department of Surgery, Royal Free Hospital National Health Service (NHS) Trust</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>North Middlesex University Hospital NHS Trust</s1><s2>London</s2><s3>GBR</s3><sZ>4 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type="abstract" xml:lang="en">Hypothesis: The causes and management of lower limb lymphedema in the Western population are different from those in the developing world. Objective: To look at the differential diagnosis, methods of investigation, and available treatments for lower limb lymphedema in the West. Data Source: A PubMed search was conducted for the years 1980-2002 with the keyword "lymphedema." English language and human subject abstracts only were analyzed, and only those articles dealing with lower limb lymphedema were further reviewed. Other articles were extracted from cross-referencing. Results: Four hundred twenty-five review articles pertaining to lymphedema were initially examined. This review summarizes the findings of relevant articles along with our own practice regarding the management of lymphedema. Conclusions: The common differential diagnosis in Western patients with lower limb swelling is secondary lymphedema, venous disease, lipedema, and adverse reaction to ipsilateral limb surgery. Lymphedema can be confirmed by a lymphoscintigram, computed tomography, magnetic resonance imaging, or ultrasound. The lymphatic anatomy is demonstrated with lymphoscintigraphy, which is particularly indicated if surgical intervention is being considered. The treatment of choice for lymphedema is multidisciplinary. In the first instance, combined physical therapy should be commenced (complete decongestive therapy), with surgery reserved for a small number of cases.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0004-0010</s0></fA01><fA02 i1="01"><s0>ARSUAX</s0></fA02><fA03 i2="1"><s0>Arch. surg. : (Chicago, 1960)</s0></fA03><fA05><s2>138</s2></fA05><fA06><s2>2</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Differential diagnosis, investigation, and current treatment of lower limb lymphedema</s1></fA08><fA11 i1="01" i2="1"><s1>TIWARI (Alok)</s1></fA11><fA11 i1="02" i2="1"><s1>CHENG (Koon-Sung)</s1></fA11><fA11 i1="03" i2="1"><s1>BUTTON (Matthew)</s1></fA11><fA11 i1="04" i2="1"><s1>MYINT (Fiona)</s1></fA11><fA11 i1="05" i2="1"><s1>HAMILTON (George)</s1></fA11><fA14 i1="01"><s1>University Department of Surgery, Royal Free Hospital National Health Service (NHS) Trust</s1><s2>London</s2><s3>GBR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></fA14><fA14 i1="02"><s1>North Middlesex University Hospital NHS Trust</s1><s2>London</s2><s3>GBR</s3><sZ>4 aut.</sZ></fA14><fA20><s1>152-161</s1></fA20><fA21><s1>2003</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>2034</s2><s5>354000104124510060</s5></fA43><fA44><s0>0000</s0><s1>© 2003 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>114 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>03-0179722</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Archives of surgery : (Chicago, IL. 1960)</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Hypothesis: The causes and management of lower limb lymphedema in the Western population are different from those in the developing world. Objective: To look at the differential diagnosis, methods of investigation, and available treatments for lower limb lymphedema in the West. Data Source: A PubMed search was conducted for the years 1980-2002 with the keyword "lymphedema." English language and human subject abstracts only were analyzed, and only those articles dealing with lower limb lymphedema were further reviewed. Other articles were extracted from cross-referencing. Results: Four hundred twenty-five review articles pertaining to lymphedema were initially examined. This review summarizes the findings of relevant articles along with our own practice regarding the management of lymphedema. Conclusions: The common differential diagnosis in Western patients with lower limb swelling is secondary lymphedema, venous disease, lipedema, and adverse reaction to ipsilateral limb surgery. Lymphedema can be confirmed by a lymphoscintigram, computed tomography, magnetic resonance imaging, or ultrasound. The lymphatic anatomy is demonstrated with lymphoscintigraphy, which is particularly indicated if surgical intervention is being considered. The treatment of choice for lymphedema is multidisciplinary. In the first instance, combined physical therapy should be commenced (complete decongestive therapy), with surgery reserved for a small number of cases.</s0></fC01><fC02 i1="01" i2="X"><s0>002B12B04</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Lymphoedème</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Lymphedema</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Linfedema</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Membre inférieur</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Lower limb</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Miembro inferior</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Diagnostic</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Diagnosis</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Diagnóstico</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Diagnostic différentiel</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Differential diagnostic</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Diagnóstico diferencial</s0><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Etiologie</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Etiology</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Etiología</s0><s5>05</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Technique</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Technique</s0><s5>06</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Técnica</s0><s5>06</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Traitement</s0><s5>07</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Treatment</s0><s5>07</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Tratamiento</s0><s5>07</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Homme</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Human</s0><s5>08</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Hombre</s0><s5>08</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Appareil circulatoire pathologie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Lymphatique pathologie</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Linfático patología</s0><s5>38</s5></fC07><fN21><s1>104</s1></fN21><fN82><s1>PSI</s1></fN82></pA></standard></inist><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Tiwari, Alok" sort="Tiwari, Alok" uniqKey="Tiwari A" first="Alok" last="Tiwari">Alok Tiwari</name></region><name sortKey="Button, Matthew" sort="Button, Matthew" uniqKey="Button M" first="Matthew" last="Button">Matthew Button</name><name sortKey="Cheng, Koon Sung" sort="Cheng, Koon Sung" uniqKey="Cheng K" first="Koon-Sung" last="Cheng">Koon-Sung Cheng</name><name sortKey="Hamilton, George" sort="Hamilton, George" uniqKey="Hamilton G" first="George" last="Hamilton">George Hamilton</name><name sortKey="Myint, Fiona" sort="Myint, Fiona" uniqKey="Myint F" first="Fiona" last="Myint">Fiona Myint</name><name sortKey="Myint, Fiona" sort="Myint, Fiona" uniqKey="Myint F" first="Fiona" last="Myint">Fiona Myint</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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