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Elephantiasis (tissue lymphoedema, elefanthiasis) is the last degree of tissue swelling caused by lymph stasis. Lymphoedema may occur as a result of congenital defects or damage or obstruction of lymphatic trunks that drain the lymph. Elephantiasis is the last stage of lymphedema and is very difficult to treat.
Elephantiasis – causes
Elephantiasis, the last stage of lymphoedema, is caused by the stagnation of lymph in the tissues. This condition can be the result of birth defects or damage to the lymphatic vessels.
Primary (congenital) lymphoedema arises as a result of abnormal capillary development, namely the absence of capillaries (aplasia of the lymphatic vessels), too little of them or defects in their structure (capillaries are usually too narrow – then we are talking about hypoplasia). Abnormally built capillaries cannot drain the lymph produced by the lymph nodes and it begins to accumulate in the tissues, causing them to swell. Cause elephantiasis there may also be an inherited genetic disorder called Milroy’s disease.
Secondary lymphedema that may lead to elephantiasis is caused by damage to the vessels that drain the lymph. This can happen as a result of chronic venous insufficiency, i.e. venous congestion, resulting from the back flow of blood in the venous vessels, or a narrowing or possibly occlusion of the veins. Lymphedema can also result from injuries, for example sprains, bacterial, viral and fungal infections that lead to inflammation of the lymphatic vessels (tropical diseases leading to clogging of the lymphatic vessels caused by nematodes and pillars are particularly dangerous) and connective tissue diseases – for example rheumatoid arthritis, systemic scleroderma, and psoriatic arthritis. Last degree lymphoedema (elephantiasis) it can also occur as a result of postoperative complications, especially after vascular operations such as saphenous vein retrieval for coronary artery bypass surgery.
A common cause elephantiasis there is a therapy for malignant neoplasms that involves the removal of lymph nodes. Such interference in the body is associated with damage to the lymphatic system, which ceases to cope with the production and drainage of lymph. Elephantiasis it is also sometimes formed after radiation therapy, which also damages the lymphatic system.
Elephantiasis – symptoms
In the course of lymphoedema, the outflow of the so-called lymph, i.e. lymph fluid, is disturbed. Lymph is produced by lymph nodes – its task is to absorb unnecessary metabolic products, especially protein, from the tissues. If the lymphatic vessels that drain the lymph are damaged (due to genetic defects, diseases or injuries), substances are not removed from the tissues and lymph accumulates in the vessels.
Initially, the swelling is latent, but if there is still lymph in the tissues, a slight swelling develops. It is the XNUMXst degree of lymphoedema. In the second degree of lymphoedema, the swelling slightly hardens, and then there is a large and constantly increasing swelling of the skin and subcutaneous tissue. This type of swelling is called elephantiasis. It usually occurs in the lower and upper limbs, as well as in the perineum (this especially applies to men).
The skin and subcutaneous tissue grows excessively due to the stagnation of lymph in it and unsightly-looking skin folds form in the place of elephantiasis. Within them, infections, ulcers and bleeding can occur. In the area affected by elephantiasis, a huge swelling develops, the skin hardens over time and shows lumpy growths and bulges. Patients complain of a dull feeling of heaviness in the limb, pain and problems with moving the limb. Lymphedema in elephantiasis is so severe that it can even lead to limb amputation.
Elephantiasis – treatment methods
Treatment of elephantiasis it is quite difficult and lasts up to several months. Special creams are applied to the diseased skin to protect it from bacterial infections, ulcers and the formation of wounds. The patient is given medications to reduce swelling and lymphatic drainage is used, i.e. a special massage that displaces the lymph in the swollen area to the place from which the lymph can be drained naturally. A method of treating elephantiasis There is also compression therapy, i.e. compression therapy, where the patient wears special clothing and compression bandages that improve muscle function and stimulate lymph flow, also from places where it tends to stagnate. It is also used as an auxiliary therapy, physical rehabilitation – physical exercises support lymph drainage.
In advanced cases of elephantiasis surgical intervention is necessary, i.e. excision of the hypertrophied subcutaneous tissue. However, it may then lead to skin necrosis.