How is chronic lymphangitis managed effectively?

Question

Hello doctor,

I am a 43-year-old male. I was born with meningomyelocele and had surgery before I turned one. At about 18 months, I also had surgery for a clubfoot. I am able to walk using elbow crutches.

Seventeen years ago, I underwent bladder augmentation surgery for urinary incontinence. The plan was to also perform an appendicular vesicostomy, but during the procedure, only the augmentation was completed. I was left with a suprapubic catheter instead.

Unfortunately, due to a spinal analgesia given through lumbar puncture, I lost sensation below both knees. Following this, I developed severe wounds and needed intravenous antibiotics. Six years ago, my right leg had to be amputated below the knee. Afterward, my left leg was affected by lymphangitis.

Three years ago, I had bladder stones (one 1.97 inches and another 1.18 inches) removed, caused by long-term retention of the suprapubic catheter. Since the spinal puncture, I continue to suffer from paresthesia.

I have attached photos of my leg along with the lymphoscintigraphy test report, which shows a blockage in the lymphatic vessels. Could you please advise what treatment options are available for my condition, and which type of doctor I should consult for surgery?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Your foot looks in a bad state (attachment removed to protect patient identity), chronic lymphedema with skin changes.

This is a long-term condition with no single cure. Several treatments may help improve your leg, including manual lymphatic drainage, complex decongestive therapy, surgery, limb elevation, and compression garments. These options can control symptoms, but ongoing care and lifelong management are necessary to maintain the best results.

All procedure has their pros and cons with varying degrees of success, and they may not match your expectations. You need to visit plastic surgeons and discuss the details.

I hope this helps.

Kindly revert if there are any queries.

Thank you.