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Page: Peripheral Oedema
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Oedema without a modifier usually refers to peripheral or dependent oedema, the accumulation of fluid in the parts of the body that are most affected by gravity. In ambulatory people these are the legs, although in those who are bedbound the first manifestation may be sacral oedema. If severe enough, peripheral oedema may progress to involve the abdominal or even thoracic wall (this may be referred to as generalized oedema or anasarca). In particular oedema states (e.g. nephrotic syndrome, see below), periorbital oedema (around the eyes) may be present.
Some phenomena may distinguish different causes of peripheral oedema. Most peripheral oedema is pitting oedema - pressing down will lead to a shift in the interstitial fluid and the formation of a small pit that resolves over seconds. Non-pitting oedema may reflect lymphedema, a form of oedema that develops when the lymph vessels are obstructed.
Causes of peripheral oedema are:
* high hydrostatic pressure of the veins, leading to poor reabsorption of fluid
o venous obstruction, e.g. deep vein thrombosis (typically one-sided)
o congestive heart failure
o varicose veins
o asymmetric compression of thigh and leg (e.g., knee pads, tight jeans)
* low oncotic pressure
o cirrhosis
o malnutrition
o nephrotic syndrome (renal protein loss)
o epidemic dropsy
* obstruction of lymph drainage
o infection
o cancer
o fibrosis after surgery
o filariasis
* inflammation (active secretion of fluid into the interstitial space due to increased membrane permeability by inflammatory mediators):
o allergic conditions (e.g. angioedema)
o any other form of inflammation (tumor - or swelling - is one of the main characteristics of inflammation)
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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