DVT

Limfedema3A

PengertianLimfedema terjadi akibat adanya disfungsi limfatik yang menimbulkan akumulasi abnormal cairan di interstisial yang mengandung protein dengan berat molekul besar.Etiologi Primer : BawaanPenyakit Milroy, dimana terdapat limfatik awal disfungsional dan kegagalan penyerapan cairan interstisial (Mutasi pada gen VEGFR-3 pada kromosom 5 )Lymphedema-distichiasis, dimana ada kegagalan katup limfatik sehingga menimbulkan refluks getah bening (mutasi pada FOXC2 )Next . .Sekunder : DidapatInfeksi & peradangan (filariasis, sirosis hepatis, gagal ginjal), trauma, keganasan, gagal jantung, dll

Signs and symptomsPembengkakan cronis pada extremitas (80%)Demam, lemahFatigue b.d ukuran dan berat extremitasRecurrent bacterial or fungal infections

Patomekanisme Peningkatan tekana Hidrostatik ?? Hipoalbumin ??Obstruksi saluran Limfe ??

LANGKAH-LANGKAH PENEGAKAN DIAGNOSISANAMNESIS, PEMERIKSAAN FISIKPEMERIKSAAN PENUNJANG (Imaging is not necessary to make the diagnosis of lymphedema, but it can be used to confirm it)Plain radiographs: To exclude abnormalities of the boneCT-scan When malignancy is suspectedMRI: When malignancy is suspected or to show lymph trunk anatomy and causes of obstructive secondary lymphedema Ultrasonography: To evaluate the lymphatic and venous systemsLymphoscintigraphy: Criterion standard for evaluation of the lymphatic systemPem. Laboratorium (If a renal or hepatic etiology is suspected)Liver function testsBlood urea nitrogen/creatinine levelsUrinalysis

PenangananPada dasarnya penanganan dengan farmako terapi pada penyakit limpoedema tidak terlalu efektif.Lebih didahulukan penanganan terhadap penyebabnya seperti sirosis hepatis, gagal jantung dan gagal ginjal.Pada limpoedema ringan bisa digunakan perban kompresi Pada limpoedema lebih berat untuk mengurangi pembekakkan bisa juga digunakan stocking selama 1-2 jam sehariJika pembengkakkan sudah berkurang penderita menggunakan stocking setinggi lutut setiap hari, setiap bangun tidur sampai sebelum tidur lagi.Perbaiki hygiene and skin care untuk hindari infeksi.compression stockings Kurangi BB (if overweight)Menghindari traumaElevating affected limb

Surgical optionSurgical treatment is palliative, not curative, and it does not obviate the need for continued medical therapy. Procedures are divided into physiologic (to improve lymphatic drainage) and excisional (removal of the affected tissues to reduce the lymphedema-related load) surgeries

komplikasiNecrosis, limfangiosarcomaPrognosisLimfedema tidak dapat disembuhkan, tapi pengobatan yag ketat dan pencegahan untuk penyakit berikutnya bisa meminilisir pembengkakan dan gejala penyerta.THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. THANK YOU. .