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It is a general
response of the body to injury or inflammation. Edema can be isolated to a small area or affect the entire body.
Edema results whenever small blood vessels become
"leaky" and release fluid into nearby tissues. The extra fluid accumulates, causing the tissue to swell
hands, arms, ankles, legs and feet. It is usually linked to the venous or lymphatic systems. Edema was formerly known as dropsy or hydropsy. Edema may be generalized or local. It can appear suddenly, but usually develops subtly - the patient may first gain weight, or wake up with puffy eyes. Many patients wait until symptoms are well advanced before seeking medical help.
CAUSES OF EDEMA
Causes of Edema
Edema is a normal response of the body to inflammation or
injury. For example, a twisted ankle, a bee sting, or a skin infection will all result in edema in the involved area. In some cases, such as in an infection, this may be beneficial. Increased fluid from the blood vessels allows more infection-fighting white blood cells to enter the affected area. Edema can also result from medical conditions or problems in the balance of substances normally present in blood. Some of the causes of edema include:
proteins in the blood act like sponges to keep fluid in the blood vessels. Low albumin may contribute to edema, but isn't usually the sole cause. Allergic reactions: Edema is a usual component of most allergic reactions. In response to the allergic exposure, the body allows nearby blood vessels to leak fluid into the affected area. Obstruction of flow: If the drainage of fluid from a body part is blocked, fluid can back up. A blood clot in the deep veins of the leg can result in leg edema. A tumor blocking lymph or blood flow will cause edema in the affected area.
other critical illnesses can cause a whole-body reaction that allows fluid to leak into tissues almost everywhere. Widespread edema throughout the body can result. Edema and heart disease (congestive heart failure): When the heart weakens and pumps blood less effectively, fluid can slowly build up, creating leg edema. If fluid buildup occurs rapidly, fluid in the lungs (pulmonary edema) can develop. Edema and liver disease: Severe liver disease (cirrhosis) results in an increase in fluid retention. Cirrhosis also leads to low levels of albumin and other proteins in the blood. Fluid leaks into the abdomen (called ascites), and can also produce leg edema.
nephrotic syndrome can result in severe leg edema, and sometimes whole-body edema (anasarca).
during pregnancy and pressure from the growing womb, mild leg edema is common during pregnancy. However, serious complications of pregnancy such as deep vein thrombosis and preeclampsia can also cause edema.
caused by head trauma, low blood sodium (hyponatremia), high altitude, brain tumors, or an obstruction to fluid drainage (hydrocephalus). Headaches, confusion, and unconsciousness or coma can be symptoms of cerebral edema.
still for a long time there is a much higher chance of swelling. Surgery - there is usually some swelling after a surgical procedure.
hormones which encourage the body to retain fluids. Pregnant women tend to retain much more sodium and water than women who are not pregnant. When a woman is pregnant her face will typically swell, as will her hands, lower limbs and feet.
vessels), calciumchannel blockers, NSAIDs drugs), estrogens, severalchemotherapy drugs, and some diabetes drugs, such cause edema
CLASIFICATION
Cutaneous edema is referred to as "pitting" when, after
pressure is applied to a small area, the indentation persist Non-pitting edema is observed when the indentation does not persist. It is associated with such conditions as lymphedemas for some time after the release of the pressure
PITTING EDEMA
MECHANISM
Six factors can contribute to the formation of edema:
increased hydrostatic pressure; reduced oncotic pressure within blood vessels; increased tissue oncotic pressure; increased blood vessel wall permeability e.g. inflammation; obstruction of fluid clearance via the lymphatic system; changes in the water retaining properties of the tissues
themselves. Raised hydrostatic pressure often reflects retention of water and sodium by the kidney.
There are many types of edema. The most common ones are:
Peripheral edema - in the feet (pedal edema), ankles,
edema).
Eye edema - in and around the eyes, e.g. macular
edema, corneal edema, periorbital edema (puffiness around the eys. Macular edema is a serious complication of diabetic retinopathy
SYMPTOMS OF EDEMA
Symptoms will mainly depend on the underlying
cause. The following refer to generalized edema: Swelling of the skin. Skin may be stretched and shiny. The skin may retain a dimple after being pressed for about ten seconds. Puffiness of the ankles, face or eyes. Aching body parts.
Stiff joints.
Weight gain. Weight loss.
DIAGNOSIS
The patient will be asked questions about his/her:
Medical history. Current state of health.
If there are indications that there may be an underlying medical condition causing the edema the doctor may order some tests, these may include: A chest X-ray Blood tests Urine tests Liver function
TREATMENT
In order to treat the edema the doctor has to diagnose the
These are drugs that raise the rate of urination, providing a means of forced dieresis. Diuresis is the increased production of urine by the kidney. There are several types of diuretics - they increase the excretion of water from the body in various different ways. Diuretics are not suitable if the patient is pregnant, or has chronic venous insufficiency
circulation.
the heart it may help move the fluid. It is important that the hand movements do not cause pain. A qualified masseuse or physical therapist will know how to do this more effectively.
COMPLICATIONS OF EDEMA
Edema is usually caused by an underlying disease or
condition. If that condition is not treated, the health consequences could be serious. Untreated edema can cause: Painful swelling. The pain can gradually get worse. Walking difficulty. Stiffness. Awkward gait.
Skin can become stretched, itchy The swollen area is more likely to become infected.
Scarring may occur between the layers of tissue. Poor blood circulation. Arteries, veins, and joints may lose their elasticity. Ulcerations of the skin.
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