Lymphatic fistula

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Classification according to ICD-10
I89.8 Other specified non-infectious diseases of the lymphatic vessels and lymph nodes
ICD-10 online (WHO version 2019)

Lymph fistula is the name given to the opening of a lymph vessel on the surface of the body.

Etiology and description

Lymph fistulas usually occur as a complication after surgery. The incidence is approximately 2%. Lymph fistula can form, especially during operations on body regions with many lymph vessels. Increased lymphatic fluid is secreted via the injured lymphatics , which can then escape through the wound.

Lymph fistulas also develop along with lymphorrhea after injury to a lymph cyst . Lymph fluid leaks from the fistula. The amount of fluid can be considerable, especially in the warm season, and can be up to three liters a day. Germs can enter the body via the lymphatic fistula, creating an erysipelas(a bacterial infection of the lymphatic system). Disinfection and sterile covering of the lymphatic fistula are therefore very important first steps. Since there is also a high loss of protein via the lymph, the primary goal is to close the fistula. In many cases, the escaping lymph is difficult for the patient to handle / drain and is associated with a loss in quality of life. Wound healing is delayed by the lymphatic fistula.

treatment

The treatment options for a lymphatic fistula are varied. They range from tight compression bandages to prophylactic gluing and surgical rehabilitation to radiation therapy (especially for lymph fistulas in the groin region ). For some years now, vacuum therapy , developed in the 1980s, has also been a therapeutic option for treating wound fistulas.

Individual evidence

  1. ↑ C. Schuchhardt and U. Herpertz: Lymphologische Terminologie. In: LymphForsch 4, 2000, pp. 31-33.
  2. ↑ a b K. Pfister et al .: For which patients is radiation therapy of inguinal lymph fistulas effective after vascular surgery? 122nd Congress of the German Society for Surgery, Munich, 2005.
  3. ↑ U. Herpertz: Edema and Lymph Drainage: Diagnosis and Therapy of Edema Diseases. Schattauer Verlag, 2006, ISBN 3-7945-2488-8 , p. 142.
  4. ^ A b N. Fortner: VAC therapy for postoperatively persistent lymph fistulas and lymphoceles after vascular surgery - first results. In: Österreichische Pflegezeitschrift 2, 2006, pp. 8–12.
  5. ↑ Claudia Rist: VAC Therapy. (PDF; 19 kB) Accessed January 10, 2010