UNILATERAL LYMPHOEDEMA AND OEDEMA IN THE FOCUS OF CLINICAL MANIFESTATIONS (WITH THE USING OF THE MATERIALS OF OWN CLINICAL OBSERVATIONS)

Abstract

Lower limb oedema/lymphoedema is actual multidisciplinary problem and common cause of contact with primary care doctor. Diagnostic algorithm includes verification of unilateral or bilateral oedema, duration of the oedema and carrying out differential search among clinical characteristics. Thoroughfully collected anamnesis and evaluation of physical investigation have crucial influence for the amount of laboratory and visualizational investigations with the aim of differentiation of oedema causes. As well it will be a problem for the family doctor to consider wide comorbidity and associated states, which produce big and emotionally-emaciating long-term clinical manifestations as lymphoedema/ oedema. The article represents the literature data concerning main causes of unilateral oedema/lymphoedema of lower limbs and diagnostic approach in case of verification of the acute/subacute oedema. According to modern recommendations it is necessary to make clinical evaluation of pretest probability of deep veins thrombosis with Wells scale. In patients with low probability and negative D-dimer results diagnois of deep veins thrombosis can be excluded without the ultrasound investigation of deep veins, in patients with high clinical suspicion on deep veins thrombosis first method of visualization is ultrasound investigation. In case of deep veins thrombosis is excluded it is necessary to consider alternative diagnoses and necessity of additional visualization of abdominal cavity organs and small pelvis with contrast venous phasic computer tomography or magnetic-resonance tomography. The article submits own observation, namely, the case of rare cancer of saliva with manifestation of tumorous process progression as unilateral lower limb oedema.