Edema is the accumulation of fluid in abnormal cavities without any signs of inflammation and pain. Here it is described as related to medicine field. I hope it will be a brief but useful document to help the students. azeemkips@yahoo.com
2. Edema
Edema is abnormal accumulation of fluid in body cavities or interstitial
spaces where connective tissue is loose.
The edematous swelling is painless, soft, pits on pressure and tends to
gravitate at the dependent body parts.
3. Etiology/Pathogenesis
1. Increased hydrostatic pressure: In this case edema occurs due to
generalized or localized congestion and hypertension of blood within
venous circulation at capillary level.
2. Decreased plasma colloid osmotic pressure: In this case edema occurs
due to decreased level of plasma protein i.e <5mg/100ml of blood. Plasma
colloid osmotic pressure decreases due to parasitism, chronic hepatitis,
chronic starvation or malnutrition
3. Obstruction of lymphatics: In this case edema occurs due to
lymphangitis, lymphadenitis or lymphosarcoma.
4. Small vessel endothelial damage: In this case edema occurs due to Local
release of vasoactive amines, toxins damage or hypoxic demage.
4. Clinical findings
Edematous swelling is cool, soft, painless, and pits on pressure but shows
no signs of acute inflammation.
Anasarca: Anasarca is accumulation of fluid in the subcutaneous tissues of
inter-mandibular space, brisket, thorax and ventral abdomen.
Ascites: Ascites is accumulation of fluid in peritoneal cavity.
Hydrothorax: Hydrothorax is accumulation of fluid in pleural cavity.
Edema may cause respiratory problems, nervous derangement or diarrhea
depending upon its location.
5. Clinical Pathology
Edematous fluid is transudate, clear, straw color, has low specific gravity,
does not clot and contains no inflammatory cells.
But some times fluid may contain high protein contents, clots and contains
blood if it is due to small vessel demage.
Lab tests for nephritis, hepatitis, peritonitis and CHF are required.
6. Differential diagnosis
1. Urolithiasis: Sub-cutaneous accumulation of urine, uriniferous smell from
breath, BUN, anuria and dysuria
2. Peritonitis: Presence of inflammatory cells, causative bacteria, exudate
and signs of toxemia.
3. Emphysema: Swelling is puffy type. It crackles under pressure.
7. Treatment
1. Specific treatment: Antibiotics, anthelminthic, cardiotonics
2. Restriction of water and intake of salt specially Na
3. Frusemide (Lasix) @ 2-3ml/SA and 25-30ml/LA, IM. Frusemide is diuretic
4. Antihistaminic: mepyramine, promethazine or corticosteroids
5. Plasma expander (6% Gelatin or dextrin)
6. Aspiration of edematous fluid using a wide bore needle
7. Vit. B complex, mineral complex
8. Diuretic mixture LA: Magnesium sulphate 200-300g, sodium citras 15-
20g, potassium nitras 15-20g, ammonium chloride 15-20g and Water (Q.S)
