Phlebolymphedema is a unique condition of combined
insufficiency of both the venous and
lymphatic systems. There is a very close relation between the venous and
lymphatic systems; therefore a venous obstruction may develop a
phlebo-lymphedema. Here we find a failure in the dual outflow system, and
although being totally different hemodynamic mechanisms, they are mutually
dependant and complementary circulation systems. Due to their intimately
integrated function, failure in one system means then additional burden and
overload of the other.
There are various causes: Primary Phlebolymphedema and
Secondary Phlebolymphedema
Primary Phlebolymphedema is caused by a congenital
defect, involving an outset of diffused trancular lymphatic malformation, affecting
both the venous and lymphatic systems. Primary Phlebolymphedema is still a
retativelly unknown condition and in the majority of cases represents the
clinical manifestation of Klippel –Trenaunay Syndrome. The presence of an
arteriovenous malformation makes the overall condition of Primary
Phlebolymphedema much harder to manage. It is also thought that Long-term strain on the lymphatic system can be a
cause of phlebo-lymphedema
Secondary Phlebolymphedema is an acquired condition
that starts off with chronic Venus insufficiency due to various causes, and
which latter leads to chronic lymphatic insufficiency. In the presence of venous hypertension, which is
characteristic of most venous disorders, the increase in lymphatic flow becomes
much greater than the lymph transport capacity. Treatment for chronic Secondary
Phlebolymphedema, consists of treating the venous abnormality, and watching
regression of the lymphatic problem.
The diagnosis of
Primary and Secondary Phlebolymphedema is based on a detailed history and
physical examination, and related tests.
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