Division of Vascular Surgery, Stony Brook Medicine, Stony Brook, NY, USA.
Center for Vein Restoration and Center for Vascular Medicine, Framingham, MA, USA.
Phlebology. 2020 Oct;35(9):650-655. doi: 10.1177/0268355520938283. Epub 2020 Jul 6.
Patients with lower limb edema are frequently referred to vascular specialists for evaluation. Multiple etiologies must be considered and often more than one cause may be present. Notably, the role of lymphatic system regardless of the underlying pathology has been underestimated. A thorough history and physical examination and a carefully considered laboratory and imaging evaluation are critical in differentiating causes. In this opinion article, we propose a diagnostic algorithm that incorporates a systematic approach to the patient with leg swelling and provides an efficient pathway for the differential diagnosis for this problem.
下肢水肿的患者常被转介至血管专科医生处进行评估。必须考虑多种病因,而且通常可能存在不止一个病因。值得注意的是,无论潜在病理如何,淋巴系统的作用都被低估了。详细的病史和体格检查,以及仔细考虑的实验室和影像学评估对于区分病因至关重要。在这篇观点文章中,我们提出了一种诊断算法,该算法将系统的方法纳入到腿部肿胀患者中,并为该问题的鉴别诊断提供了一种有效的途径。