Ödem
Edema is the accumulation of fluid in tissues. It is caused by an imbalance between forces holding fluids in the vasculature and tissues. Fluids are normally held in a steady state between tissues and vasculature by homeostasis between these forces (Starling equation) :
- capillary hydrostatic pressure - drives fluid out of the vasculature into tissues
- plasma colloid osmotic pressure - keeps fluid in the vasculature, preventing extravasation into the tissues
- tissue colloid osmotic pressure - keeps fluid in the tissues
Clinical presentation
- peripheral edema
- pulmonary edema
- pleural effusions
- ascites
Pathology
Etiology
- increased capillary hydrostatic pressure
- congestive cardiac failure
- venous obstruction, compression, or thrombosis
- ascites
- constrictive pericarditis
- arteriolar dilatation
- reduced plasma colloid osmotic pressure
- ascites and liver cirrhosis
- nephrotic syndrome
- malnutrition
- protein-losing enteropathy
- increased tissue colloid osmotic pressure
- increased vascular permeability
- inflammation
- infection
- reduced lymphatic clearance
- lymphedema
- lymphatic obstruction
- increased salt retention (causes both increased hydrostatic pressure and reduced plasma colloid osmotic pressure by fluid retention)
- renal insufficiency
Siehe auch:
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Assoziationen und Differentialdiagnosen zu Ödem: