D’s mother shared that her son has been suffering from “elephantiasis” since he was 4 years old, with his right leg significantly larger than his left, causing difficulty in walking. The family sought medical advice from various places, but the exact cause of the condition remained unclear, leaving them hesitant to intervene. “The illness greatly impacted his daily life and studies, so we once turned to a traditional healer who made incisions in his leg, releasing fluid. However, the condition worsened, leading to severe infection,” D’s mother recounted.
D’s mother caring for her son post-surgery at the hospital.
Recently, D and his mother traveled from their hometown to Hospital E for a consultation, holding onto the hope of a brighter future. With the mindset of “where there’s life, there’s hope,” they sought a cure for his condition.
Dr. Nguyen Dinh Lien, Head of the Department of Urology and Andrology, noted that upon arrival, the patient and his family were anxious and self-conscious, and D appeared frail and malnourished. After examination, Dr. Lien diagnosed D with nephrotic syndrome, a condition causing proteinuria. Additionally, D had lymphatic obstruction in his right leg, resulting in severe swelling, often referred to as “elephantiasis.” His scrotum was also significantly enlarged, a condition known as “scrotal elephantiasis,” measuring the size of a bowl.
“Years of protein loss through urine led to his malnourished state,” Dr. Lien explained.
According to Dr. Lien, nephrotic syndrome can stem from various causes, with filariasis being the most common. Other causes include kidney trauma from accidents, renal pelvic fractures, or cancerous invasions damaging the lymphatic system.
“Given the patient’s history and the prevalence of filariasis in his region, we suspect this as the primary cause. However, our immediate focus is on treating D to stabilize his condition,” Dr. Lien stated.
The right leg, affected by “elephantiasis,” shows significant improvement post-surgery.
Dr. Lien treated D by removing the obstructed lymphatic vessels to prevent further proteinuria. Once stabilized, Dr. Lien collaborated with Dr. Nguyen Dinh Minh, Head of the Department of Plastic and Maxillofacial Surgery, to perform microsurgery to reconnect the lymphatic vessels in D’s right leg. Post-treatment, D’s proteinuria ceased, and his right leg significantly reduced in size and softened. He remains under observation.
D and his family are overjoyed with the positive outcomes. “After discharge, I will strictly follow the doctors’ instructions. I hope this marks a new chapter in my life. I am deeply grateful to the doctors,” D expressed.
Dr. Nguyen Dinh Minh remarked: “This is an extremely rare case, one that a doctor might encounter only once in their career, involving both lymphatic leakage and elephantiasis.”
Dr. Nguyen Dinh Minh described the case as exceptionally rare, one that a doctor might encounter only once in their lifetime.
Dr. Minh highlighted the challenges in treating D due to the long-standing nature of his condition, which caused fibrosis and hardening of the leg. This made lymphatic vessel reconnection more difficult than in typical cases.
“Fortunately, D’s youth meant his venous system remained healthy. During surgery, we used high-magnification microscopes and ultra-fine sutures to reconnect the lymphatic vessels to the venous system, restoring lymphatic flow,” Dr. Minh explained.
The doctors emphasized that while this is a rare condition, early detection and treatment significantly improve outcomes and quality of life. They advised against traditional remedies like incisions, which can exacerbate the condition and lead to further complications.
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