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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes swelling and hardness in leg post leg bypass surgery?

Answered by
Dr. Karl Logan

Orthopaedic Surgeon

Practicing since :1999

Answered : 705 Questions

Posted on Mon, 19 Oct 2015 in Bones, Muscles and Joints
Question: I've had "Bypass" Surgery, on my right leg, and 2 amputations on my right foot ( the little toe and the big toe.
I've had several infections during this time , as well as afterwards, including MRSA. I'm Diabetic and am going to wound care since last late November. Last year when I was discharged, I've had swelling and hardness of the skin on my right leg and this won't go away. Could I have Lymphoma ?
Thank you,
Answered by Dr. Karl Logan 2 hours later
Brief Answer:

Detailed Answer:

thanks for your question.

what you are describing sounds consistent with Lipodermatosclerosis.

this is an inflammatory condition of the fat layer under your skin.

Pain may be the first noticed symptom. People with lipodermatosclerosis have tapering of their legs above the ankles, forming a constricting band resembling an inverted champagne bottle. In addition, there may be brownish-red pigmentation and induration.

The exact cause of lipodermatosclerosis is unknown. Venous disease, such as venous incompetence, venous hypertension, and body mass (obesity) may be relevant to the underlying pathogenesis.

Increased blood pressure in the veins (venous hypertension) can cause diffusion of substances, including fibrin, out of capillaries. Fibrotic tissue may predispose the tissue to ulceration. Recurrent ulceration and fat necrosis is associated with lipodermatosclerosis. In advanced lipodermatosclerosis the proximal leg swells from chronic venous obstruction and the lower leg shrinks from chronic ulceration and fat necrosis resulting in the inverted coke bottle appearance of the lower leg.

The management of lipodermatosclerosis may include treating venous insufficiency with leg elevation and elastic compression stockings; in some difficult cases, the condition may be improved with the additional use of the fibrinolytic agent, stanozol. Fibrinolytic agents use an enzymatic action to help dissolve blood clots. Stanozol is injected directly into the affected area, Venous Ablation has also been known to help circulation in patients.

I hope this answers your question.

best wishes
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