ABSTRACT

Lymphatic insufficiency is a generic term for the pathological buildup of liquid and solute in the interstitial matrix from an impaired or overburdened lymphatic drainage system. In chronic lymphedema of the extremities, the prototype disorder for lymph stasis, there is commonly a long latent period before evolution of unremitting edema, sometimes interspersed with intermittent episodes of inflammation or infection and finally culminating in brawny induration with tissue fibrosis. Bowel edema regularly accompanies operative manipulation of the intestine, mechanical obstruction, and gastroenteritis from bacterial or viral infection. Long-standing bowel edema and succulent mesenteric lymphadenopathy are well established anatomical features. Defective intestinal lymph flow is also responsible for the chylous disorders. Whereas primary lymphedema is the prototype disorder for low output failure of the lymph circulation, ascites from cirrhosis is the prototype for dynamic insufficiency or high output failure of lymph flow.