Home > Diseases and Conditions > Lymphatic obstruction
  • We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Expert-reviewed information summary about the treatment of lymphedema, a condition in which lymph fluid builds up in tissues and causes swelling.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Lymphatic obstruction

Lymphedema

Last reviewed: September 3, 2012.

Lymphatic obstruction is a blockage of the lymph vessels that drain fluid from tissues throughout the body and allow immune cells to travel where they are needed. Lymphatic obstruction may cause lymphedema, which means swelling due to a blockage of the lymph passages.

Causes, incidence, and risk factors

The most common reason for lymphatic obstruction is the removal or enlargement of the lymph nodes.

Causes of lymphatic obstruction include:

In Western societies, one of the most common causes of lymphedema is removal of the breast (mastectomy) and underarm lymph tissue for breast cancer. This causes lymphedema of the arm in 10 - 15% of patients, because the lymphatic drainage of the arm passes through the armpit (axilla).

Rare forms of lymphedema that are present from birth (congenital) may result from problems in the development of the lymphatic vessels.

Symptoms

The main symptom is persistent (chronic) swelling, usually of the arm or leg.

Signs and tests

The doctor will perform a physical exam and ask questions about your medical history.

The following tests may be done:

Treatment

Treatment for lymphedema includes:

  • Compression (usually with multilayered bandages)
  • Manual lymph drainage (MLD)
  • Range of motion exercises

Manual lymph drainage is a light massage therapy technique in which the skin is moved in certain directions based on the structure of the lymphatic system. This helps the lymph fluid drain through the proper channels.

Treatment also includes skin care to prevent injuries, infection, and skin breakdown, as well as light exercise and movement programs. Exercise should be carefully designed by your doctor and a physical therapist. It should help drainage without leading to swelling, which could make your condition worse.

Wearing compression stockings on the affected area or using a pneumatic compression pump on and off may be helpful. Your doctor and physical therapist will decide which compression methods are best.

Surgery is used in some cases, but it has limited success. The surgeon must have a lot of experience with this type of procedure. You will still need physical therapy after surgery to reduce lymphedema.

Types of surgery include:

  • Removal of abnormal lymphatic tissue
  • Transplant of normal lymphatic tissues to areas with abnormal lymphatic drainage (less common)

Rarely, the surgeon will bypass abnormal lymph tissue using vein grafts. These procedures are not usually successful and are often done experimentally.

Expectations (prognosis)

Lymphedema is a chronic disease that usually requires lifelong management. In some cases, lymphedema improves with time. However, some swelling is usually permanent.

Complications

In addition to swelling, the most common complications include:

You must be vigilant about skin care and hygiene. There is also a small risk of developing a lymph-tissue type of cancer.

Calling your health care provider

See your doctor if you have swelling of your arms, legs, or lymph nodes that does not go away.

Prevention

Most surgeons now use a technique called sentinel lymph node sampling to reduce your risk of lymphedema after breast cancer surgery. However, this technique is not always appropriate or effective.

References

  1. Kerchner K, Fleischer A, Yosipovitch G. Lower extremity lymphedema update: pathophysiology, diagnosis, and treatment guidelines. J Am Acad Dermatol. 2008;59:324-331. [PubMed: 18513827]
  2. Davidson N. Breast cancer and benign breast disorders. InGoldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 204.
  3. Diemert DJ. Tissue nematode infections. In Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier;2011:chap 366.

Review Date: 9/3/2012.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Physical therapies for reducing and controlling lymphoedema of the limbsPhysical therapies for reducing and controlling lymphoedema of the limbs
    Lymphoedema is the build up of excess fluid in the body tissues because of obstruction of lymphatic drainage back into the bloodstream. The affected limb becomes swollen, distorted in shape with pain, discomfort all of which impair movement and daily activities. It can be caused by a congenital abnormality, chronic venous insufficiency, damage to the lymphatic system following treatment of cancer or filariasis, a parasitic infection endemic in parts of India and Africa. Skin care is important as the affected tissues gradually thicken and are susceptible to inflammation and infections. People are also encouraged to exercise regularly and control their weight. Different physical treatments aimed at improved lymph drainage include multi‐layer bandaging, manual lymph drainage (MLD), self‐administered massage and compression sleeves or hosiery.
See all (2) ...

Figures

  • Lymphatic system.
    Yellow nail syndrome.

PubMed Health Blog...

read all...

MedlinePlus.gov links to free, reliable, up-to-date health information from the National Institutes of Health (NIH) and other trusted health organizations.