English
- Dropsy
- Water in the legs
- Abdominal fluid
- Swollen legs
- Pleural effusion
- Ascitis
- Water storage
- Edema
- Ascites
Definition Edema
Edema is an accumulation of fluid in the interstitial tissue (water retention). Interstitial tissue is intermediate tissue, usually connective tissue, which subdivides organs. The consequences of oedema are e.g. swelling of the legs. If it is very pronounced, hydropsanasarka (accumulation of water, extensive oedema, especially of the subcutaneous cell tissue) and cave effusions occur, resulting in water accumulation in the lungs (pleural effusion) or in the abdomen (ascitis).
Symptoms of edema
The symptoms of edema include two main characteristics. On the one hand, there is pain, which can be explained by the reduced blood circulation, and on the other hand, there are typical discolorations. The discolorations are three-colored and are in the following order: It is important that the edema always occurs symmetrically, i.e. it affects both hands, feet, etc.
Water in the feet is a particularly common symptom. Smoking typically worsens the symptoms, as nicotine constricts the blood vessels.
- White discoloration (narrowing of the finger arteries = vasoconstriction of the Aa. Digitales)
- Blue discoloration (cyanosis = oxygen deficiency)
- Red discoloration (increased blood circulation (reactive hyperemia) as a result of a lack of blood circulation)
Diagnosis of edema
When diagnosing edema, a distinction must be made between the different types of edema. There are generalized edemas in which the accumulation of fluid in the tissue is usually low in protein. These oedemas consist of so-called transudate, which is pressed through the inner lining of the blood vessels (endothelium) by excessive pressure.
The edema therefore consists mainly of water. There are also edemas that consist of exudate. In inflammatory processes, this exudate enters the tissue by opening the endothelial barriers and is rich in protein.
So it is not only water that leaves the vessel, but also protein-rich blood components that attract further water. Pulmonary edema, for example, can be detected both by auscultation (through the stethoscope) and by percussion (tapping). Through the stethoscope, one hears so-called coarse-bubble moist rales and when tapping the lung, one hears a darker tapping sound compared to healthy lung tissue.
Pulmonary edema usually occurs symmetrically. In ascites, the tapping sound is also muffled and a fluctuation wave can be detected. A wave of fluctuation occurs when the patient’s abdomen is pushed on one side and a wave is felt on the other side with the laid-on hand moving through the abdomen.
The examination is best performed in a four-footed position. In ultrasound (sonography) the detection limit is 100ml. Edema in the legs can be detected simply by pressing the tissue with a finger.
If oedema is present, a dent remains in the tissue, which will disappear after some time. Oedema is water retention in the tissue and therefore shows itself in different regions of the body. They have the most different causes and underlying diseases but often show themselves in the same way.
Smaller swellings are initially not noticed by the affected person and typical swellings of the legs in the evening after a long working day or long standing and walking are often considered normal. However, if edema persists and continues to increase, the patient will eventually gain weight for no reason. The circumference of the leg can also be measured, which is also enlarged.
Doctors thus also measure the condition of the edema in the hospital and also check the patient’s fluid intake. The skin is usually smooth, taut and shiny. The skin can also be marbled and feel colder.
Since the water retention can also press off the supplying vessels of the tissue, edema also results in a reduced blood flow. This may also cause a tingling sensation and altered sensation. A typical test for edema is to press the swelling with one or more fingers. If oedema is present, the pressed skin area remains so for a short time and then slowly recedes.This is characteristic of swelling with water retention.
