Ascites swelling of the legs
Dropsy (swelling) is an excessive accumulation of fluid in the subcutaneous fat tissue, tissues or serous cavities of the body.
The cause of dropsy (accumulation of the transudate, orwatery liquid) is a violation of the process of inflow and outflow of tissue fluid. Through the capillaries of blood vessels, there is an exchange between the fluid in the tissues of the body and the circulating blood. The exit of fluid through the vascular wall into the surrounding tissues is called "transudation", this process is continuous. Edemas are formed on the condition that a larger volume of fluid sweeps into the surrounding tissue from the capillaries than is absorbed as a result of the reverse outflow, in some cases, the reverse absorption may completely stop.
Under the pressure of a watery liquid insubcutaneous tissue, the skin swells, resulting in an increase in the volume of certain parts of the body of a sick person. In the area of swelling, the skin can resemble dough. When palpation of edematous tissue, pits formed with light pressure, remain on the skin for a long time after the cessation of exposure. There is a pallor and coldness of the skin, which is associated with a violation of the blood supply of tissues due to compression of the blood vessels by edematous fluid. Water drops form a clear liquid, which contains protein in a very low concentration.
Edema serves as a characteristic symptom of the mostvarious diseases and pathological conditions. It is an important diagnostic feature for physicians when examining patients suffering from general or local circulatory disturbance, kidney disease, and disorders in the regulation of water-salt metabolism.
At the site of localization, dropsy is divided intolocal and general. Local edema is caused by the infringement of inflow and outflow of fluid in a separate tissue site or in a certain organ, the cause of such dropsy in most cases becomes compression of venous vessels. The occlusion (compression) of the portal vein causes ascites. which is also called a dropsy of the abdominal cavity, and a violation of blood circulation in the femoral vein causes swelling of the legs.
Common edema leads to a violation of waterbalance in the whole body, which can be judged by cardiac edema. The main causes that lead to a change in the fluid flow balance in limited areas are: increased fluid pressure in small vessels (capillaries), a reduction in the oncotic pressure of the plasma, an increase in the oncotic pressure of the interstitial fluid, a decrease in pressure on the tissues, a high permeability of the capillary vessels, plasma.
Given the factor that becomes leading inthe development of the pathological process, dropsy is divided into mechanical, hypo-oncotic, membranogenic and lymphatic. Mechanical, or stagnant, swelling occurs due to high hydrostatic pressure in small blood vessels and disturbance of the reverse flow of venous blood, caused by blockage or mechanical compression of blood vessels. Such pressure can be exerted by the pregnant uterus and enlarged liver. The cause of plugging of veins may be phlebothrombosis.
When the concentration of protein in the blood decreasesdevelop hypo-oncotic edema, while the protein content does not exceed 50 g / l. The greatest value in this case is the low content of albumin in blood (below 25 g / l), since they have a greater osmotic activity than globulins. The maximum drop in oncotic pressure and extensive edema accompany the nephrotic syndrome.
The growth of the oncotic pressure of the interstitialfluid, accompanied by a change in the permeability of capillary membranes and sweeping into the tissues of the filtrate saturated with protein, is an important factor in the formation of edema of any origin. Edema, arising from acute nephritis, cardiac and respiratory failure, are closely related to increased permeability of membranes. Cell membranes can be affected by toxins (snake venom, bacterial toxins, poisonous substances, fever).
Symptoms of dropsy of lymphatic origin arisewhen the inverse current of lymph is disturbed, which causes the accumulation of fluid saturated with protein. Changes in lymph flow and associated edema accompany congenital hypoplasia of the lymph nodes, their malignant degeneration, nephrotic and hunger edema, and ascites.
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Treatment of dropsy in an acute period is carried outconservatively. The patient is prescribed analgesics, wearing a suspension, antibacterial drugs, cold at the initial stage of treatment and thermal procedures some time after the formation of edema.
Treatment of chronic dropsy may bepuncture, injectable or operative. As a result of puncture, fluid is removed from the edema formation site. Injection method involves, in addition to the procedure for removing fluid, the introduction of medications that contribute to cicatricial alterations of alcohol, formalin, carbolic acid and hydrocortisone. These methods can cause a number of complications and do not exclude the possibility of recurrence of the disease, so they are not widely used in the treatment of dropsy.
There are many methods of surgical treatment of the disease, which rarely cause complications and have a favorable prognosis.