FACTITIOUS LYMPHEDEMA OF THE UPPER-LIMB
A case of factitious lymphedema experienced in a 24 year old female (cashier of a supermarket) caused by a tourniquet was reported. Edema had developed in the dominant hand during thecourse of physiotherapy for shoulder-arm-neck syndrome. As the possibility of thoracic outlet syndrome was considered, she had also received surgery. But the exploratory surgery in this case did not cure the edema eternally. Edema began to recure from the 8th day after surgery. When a plaster cast was applied and the patient was unable to gain access to the limb to apply a tourniquet, the edema markedly improved. The patient had been recognized as having an occupation related ailment, and had been receiving compensation benefits from two and a half years ago. It was felt that hysteria loomed in the background of this case. As both surgery and physiotherapy is ineffective tothis lymphedema, the surgeon should discontinue treatment and refer the patient for psychiatric care.