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Chronic peripheral oedema and lymphoedema 

Chronic peripheral oedema and lymphoedema
Chapter:
Chronic peripheral oedema and lymphoedema
Author(s):

Peter S. Mortimer

DOI:
10.1093/med/9780198746690.003.0382
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date: 05 March 2021

Lymph transport, not venous reabsorption, is the main process responsible for interstitial fluid drainage. Oedema develops when the microvascular filtration rate exceeds lymph drainage for a sufficient period, and any chronic oedema represents a failure of lymph drainage. In practice, any chronic oedema should be managed in the same way as lymphedema. The primary function of the lymphatic vessels is to drain the plasma filtrate within body tissues and return it to the blood circulation. Lymphatic vessels also have an important immune surveillance function, as they are the main drainage route from the tissues for immune active cells such as dendritic cells, lymphocytes, and macrophages. Intestinal lymphatics are responsible for fat absorption. Impaired lymphatic function leads to disturbed fluid homeostasis (swelling), dampened immune responses (infection), and disturbed fat homeostasis (increased peripheral fat deposition), all features of lymphoedema. Lymphatic vessels are also the preferential route for cancer spread.

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