OEDEMA PATHOLOGY (1).pptx

oedema

1. Pathophysiology of oedema Dr SACHINKUMAR PANDEY MBBS , FID(FELLOWSHIP IN DIABETES)

2. What is oedema? Is a palpable swelling produced by the expansion of the interstitial fluid volume. Is a medical term for swelling caused by a collection of fluid in the small spaces that surrounds the body’s tissues and organs. Becomes evident when the interstitial fluid increased by 2.5- 3L .

3. Types of oedema Classification: According to pathophysiological mechanism: Transudate (low protein content) Exudate (high protein content) According to location: Localized Generalized According to clinical finding: Pitting Non-pitting.

4. Examples Localised: Venous edema, Lymphatic edema, allergy/agioedema, inflammation Generalised: Cardiac edema, Hepatic edema, Renal edema, Endocrine edema Pitting: due to cardiac & renal causes, liver disease, calcium channel blockers, early stage of filiarisis Non- pitting: Myxoedema, Elephantiasis, Angioneurotic

5. Organ specific… Brain – cerebral edema Lung – (intraalveolar) pulmonary edema (intrapleural) pleural effusion Peritoneum – ascites Massive and generalised edema - anasarca

6. Mechanism of Action of Oedema

7. 1. Increased Hydrostatic Pressure Rise in hydrostatic pressure at the venular end of capillaries to a level more than plasma oncotic pressure Minimal/No Reabsorption of fluid at venular end OEDEMA

8. 2. Reduced Plasma Oncotic Pressure Reduced albumin synthesis in liver/ Protein malnutrition Fall in plasma oncotic pressure Net movement of fluid into interstitial tissues OEDEMA

9. 3. Lymphatic Obstruction Impaired lymphatic drainage Localised LymphOEDEMA Radial mastectomy for Ca breast Pressure on main lymph ducts Inflammation of lymphatics Occlusion of Lymphatics by malignant cells Milroy’s disease

10. 4. Sodium and Water Retention Hypovolaemia Renal Vasoconstriction Renin ADH GFR Aldosterone Reabsorption of water Renal retention of Na and water OEDEMA

11. 5. Inflammation Capillary endothelial injury by toxins/ histamine/ anoxia/ drugs Endothelial gap Increased capillary permeability to plasma protein Decreased plasma oncotic pressure OEDEMA

12. BILATERAL PEDAL EDEMA