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[The Swollen Leg in Vascular Medical Practice].

Resource type
Authors/contributors
Title
[The Swollen Leg in Vascular Medical Practice].
Abstract
In case of an acute leg swelling a deep leg vein thrombosis needs to be excluded. In order to do this, compression sonography and the D-dimer-test are applied in the framework of an established diagnostic algorithm. The ensuing therapy consists in anticoagulation and compression.In case of a chronic leg swelling anamnesis and a clinical check-up often lead to a differential diagnosis. Chronic venous insufficiency is a generic term for a disturbed venous backflow. It is caused by an obstruction or an antegrade or retrograde flow insufficiency. Most common diseases in this context are varicosis or a post-thrombotic syndrome. Sonography and special function tests provide a diagnosis. The basic therapy consists in regular exercise, normalization of weight and compression therapy. In case of a hemodynamically relevant varicose vein surgery or endovascular treatment is advisable. The post-thrombotic syndrome must be treated consistently with the basic therapy.A lymphedema may be hereditary or acquired. In a first step diseases like neoplasia need to be excluded. The initial therapy consists in manual lymph drainage in combination with special compression bandages. Flat knit stockings should be prescribed. Surgical treatment is reserved for special circumstances.A lipedema is clinically diagnosed. It is characterized by lipohypertrophia, pressure sensitivity of the tissue and susceptibility to hematomas. Treatment options include weight reduction, regular exercise, lymph drainage and compression therapy, in some cases liposuction.
Publication
Deutsche medizinische Wochenschrift (1946)
Volume
144
Issue
6
Pages
398-410
Date
2019 Mar
Journal Abbr
Dtsch Med Wochenschr
Language
ger
ISSN
1439-4413 0012-0472
Rights
© Georg Thieme Verlag KG Stuttgart · New York.
Extra
Place: Germany
Citation
Präve, F., & Hoffmann, K. (2019). [The Swollen Leg in Vascular Medical Practice]. Deutsche medizinische Wochenschrift (1946), 144(6), 398–410. https://doi.org/10.1055/a-0379-9997