Espinosa-de-Los-Monteros Antonio, Hinojosa Carlos A, Abarca Leonardo, Iglesias Martín
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
J Vasc Surg. 2009 Jan;49(1):222-4. doi: 10.1016/j.jvs.2008.07.073.
In this report, we describe a case of bilateral non-syndromic hereditary lymphedema praecox of lower legs. The patient was diagnosed at age 16. Ten years later, he was unable to ambulate due to increased bilateral lower leg volume, continuous pain, and recurrent episodes of cellulitis. He was treated at our tertiary-care center with compression therapy and circumferential liposuction of lower legs, ankles, and dorsum of feet in order to remove hypertrophic fat deposits, facilitate conservative therapy, and decrease further risk of cellulitis. No complications were seen and compression therapy was continued. Fourteen month follow-up reveals no increase in leg volume over time, absence of pain, and no further episodes of cellulitis with complete ability to ambulate and return to normal activities. Even when it does not eliminate the underlying cause of primary lymphedema, combined therapy consisting of compression and liposuction is safe and is able to achieve control, at least on a short term, of clinically disabling conditions associated with advanced stages.
在本报告中，我们描述了一例双侧非综合征性早发性小腿遗传性淋巴水肿病例。该患者16岁时被诊断出患病。十年后，由于双侧小腿体积增大、持续疼痛以及蜂窝织炎反复发作，他无法行走。他在我们的三级医疗中心接受了治疗，采用了压迫疗法以及对小腿、脚踝和足背进行环形抽脂，以去除肥厚的脂肪沉积，促进保守治疗，并降低蜂窝织炎的进一步风险。未观察到并发症，压迫疗法持续进行。14个月的随访显示，腿部体积未随时间增加，无疼痛，也没有进一步的蜂窝织炎发作，患者能够完全行走并恢复正常活动。即使不能消除原发性淋巴水肿的根本原因，由压迫和抽脂组成的联合治疗也是安全的，并且至少在短期内能够控制与晚期相关的临床致残状况。
