<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022016000300126</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Manejo quirúrgico del linfedema escrotal severo]]></article-title>
<article-title xml:lang="en"><![CDATA[Surgical management of severe scrotal lymphedema]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Badilla-Mora]]></surname>
<given-names><![CDATA[Jorge]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ávila-Hernández]]></surname>
<given-names><![CDATA[Susana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pastor-Pacheco]]></surname>
<given-names><![CDATA[Luis]]></given-names>
</name>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital México CCSS Servicio de Cirugía Plástica y Reconstructiva ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,CCSS CENDEISSS UCR]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2016</year>
</pub-date>
<volume>58</volume>
<numero>3</numero>
<fpage>126</fpage>
<lpage>128</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022016000300126&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022016000300126&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022016000300126&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: El linfedema consiste en la retención de líquido linfático en los tejidos, causada por una obstrucción del sistema linfático. El sistema linfático devuelve el líquido intersticial al conducto torácico y este luego al torrente sanguíneo, y de allí se recircula a los tejidos. Puede ser un fenómeno aislado o no, tal como manifestación de una displasia linfática congénita (primaria), desarrollada durante la etapa tardía de linfangiogénesis; o puede ser secundario, es decir, causado por una lesión u obstrucción en los vasos linfáticos, ya sea por disección quirúrgica radical, irradiación, malignidad, linfangitis con linfagioesclerosis, trauma o causa idiopática. Los síntomas pueden incluir fatiga grave, edema focal o generalizado en algunas regiones del cuerpo, así como descoloración de la piel que recubre el linfedema y, finalmente, la deformidad, que en el caso de las extremidades inferiores se llama elefantiasis. El linfedema no solo puede causar desfiguración, sino también limitación del estilo de vida, e incluso trastornos psicológicos. Se presenta el caso de un paciente de 45 años, portador de linfedema severo (elefantiasis) de miembros inferiores crónico y del saco escrotal, valorado y manejado quirúrgicamente en el Servicio de Cirugía Plástica y Reconstructiva del Hospital México.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Lymphedema is a localized retention of lymphatic fluid in the tissues, usually caused by a blockage of the vessels that carry lymph. The lymphatic system returns the interstitial fluid to the thoracic duct and this in turn, brings it to the bloodstream, where it is recirculated to the tissues. It may be an isolated phenomenon or not, as a manifestation of a congenital lymphatic dysplasia (primary) developed during the late stage of lymphangiogenesis; or it may be secondary, caused by an injury or blockage to the lymphatic vessels, either by radical surgical dissection, irradiation, malignancy, lymphangitis with lymphangiosclerosis, trauma or of an idiopathic cause. Symptoms may include severe fatigue, focal or generalized edema of some regions of the body, as well as discoloration of the skin overlying the affected area, and eventually deformity, which is called elephantiasis when it refers to the lower limbs. Lymphedema not only may cause disfiguration, but also can limit lifestyle, and even cause psychological disorders. We present the case of a 45-year old patient with severe chronic lower limb (elephantiasis), and scrotal sac lymphedema, who was evaluated and successfully treated by the Department of Plastic and Reconstructive Surgery at the Hospital Mexico.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[linfedema escrotal]]></kwd>
<kwd lng="es"><![CDATA[filariasis]]></kwd>
<kwd lng="es"><![CDATA[elefantiasis escrotal]]></kwd>
<kwd lng="en"><![CDATA[scrotal lymphedema]]></kwd>
<kwd lng="en"><![CDATA[filariasis]]></kwd>
<kwd lng="en"><![CDATA[scrotal elephantiasis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Modolin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mitre]]></surname>
<given-names><![CDATA[AI]]></given-names>
</name>
<name>
<surname><![CDATA[da Silva]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Cintra]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Quagliano]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
<name>
<surname><![CDATA[Arap]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical treatment of lymphedema of the penis and scrotum]]></article-title>
<source><![CDATA[Clinics]]></source>
<year>2006</year>
<volume>61</volume>
<page-range>289-94</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Molyneux]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tropical Lymphedemas--control and prevention]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2012</year>
<volume>366</volume>
<page-range>1169-71</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gueglio]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Quijada]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Salas]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Daels]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Tejerizo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Chernobilsky]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Linfedema escrotal gigante por enfermedad de Milroy]]></article-title>
<source><![CDATA[Arch Esp Urol]]></source>
<year>2003</year>
<volume>56</volume>
<page-range>949-52</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="">
<collab>International Society of Lymphology</collab>
<article-title xml:lang=""><![CDATA[The diagnosis and treatment of peripheral lymphedema: 2013 Consensus document of international society of lymphology]]></article-title>
<source><![CDATA[Lymphology]]></source>
<year>2013</year>
<volume>46</volume>
<page-range>1-11</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Warren]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lymphedema: A comprehensive review]]></article-title>
<source><![CDATA[Ann Plast Surg]]></source>
<year>2007</year>
<volume>59</volume>
<page-range>464-72</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tretbar]]></surname>
<given-names><![CDATA[LL]]></given-names>
</name>
<name>
<surname><![CDATA[Morgan]]></surname>
<given-names><![CDATA[CL]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[BB]]></given-names>
</name>
<name>
<surname><![CDATA[Simonian]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Blondeau]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Lymphedema: diagnosis and treatment]]></article-title>
<source><![CDATA[lymphedema]]></source>
<year>2007</year>
<edition>1</edition>
<page-range>12-20</page-range><publisher-loc><![CDATA[London ]]></publisher-loc>
<publisher-name><![CDATA[Springer-Verlag]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hidalgo]]></surname>
<given-names><![CDATA[ER1]]></given-names>
</name>
<name>
<surname><![CDATA[García-Moreno]]></surname>
<given-names><![CDATA[AL]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[EB]]></given-names>
</name>
<name>
<surname><![CDATA[Crespo]]></surname>
<given-names><![CDATA[AS]]></given-names>
</name>
<name>
<surname><![CDATA[Casado]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Núñez]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical treatment in a case of giant scrotal lymphedema]]></article-title>
<source><![CDATA[Arch Esp Urol]]></source>
<year>2011</year>
<volume>64</volume>
<page-range>121-4</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Halperin]]></surname>
<given-names><![CDATA[TJ]]></given-names>
</name>
<name>
<surname><![CDATA[Slavin]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Olumi]]></surname>
<given-names><![CDATA[AF]]></given-names>
</name>
<name>
<surname><![CDATA[Borud]]></surname>
<given-names><![CDATA[LJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical management of scrotal lymphedema using local flaps]]></article-title>
<source><![CDATA[Ann Plast Surg]]></source>
<year>2007</year>
<volume>59</volume>
<page-range>67-72</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Torio-Padron]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Björn Stark]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Földi]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Simunovic]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Treatment of male genital lymphedema: An integrated concept]]></article-title>
<source><![CDATA[J Plast Reconstr Aesthet Surg]]></source>
<year>2014</year>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
