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admin | Category: Erective Dysfunction 2016 | 22.02.2015
Pitting edema: Observable swelling of body tissues due to fluid accumulation that may be demonstrated by applying pressure to the swollen area (such as by depressing the skin with a finger).
Anasarca is generally due to water retention, blood vessel defect, and lymphatic obstruction.
In the presence of hypoalbuminemia as seen in nephrotic syndrome or other disease entities, anasarca occurs as a result of low osmotic pressure in the capillaries. As a result, Kimmelstiel-Wilson nodules develop, obstructing the glomerular blood flow and damaging the nephrons (kidney cells). As a result, there will be decreased blood volume in the arteries because of sluggish blood flow. But if we are talking about generalized edema or anasarca, then we have a big problem as it mirrors a serious underlying condition. If the albumin is normal, a common underlying cause is heart failure and this can be observed in patients with jugular venous distention (JVD) on the side of the neck or decreased cardiac output (CO) as the heart fails to pump sufficient blood to cater the needs of the entire body.
Anasarca is not a disease entity by itself but rather, it is a sign that something severe is going on inside the body.
Bed rest is required for faster recovery especially if the cause of anasarca is congestive heart failure or liver cirrhosis. For swelling of the lower extremities, lie down flat on your back and elevate your legs and feet against the wall.
Diuretics are used for congestive heart failure, pulmonary edema, and excessive sodium ingestion.

For liver and kidney failure, hemodialysis may be used to get rid of the excessive interstitial fluid. In congestive heart failure, do not overuse diuretics as it may lead to further decreased cardiac output, azotemia (accumulation of proteins in the blood), and hypokalemia (decreased serum potassium levels). In anasarca caused by liver diseases, spironolactone (a potassium-sparing diuretic) is the diuretic of choice. If the pressing causes an indentation that persists for some time after the release of the pressure, the edema is referred to as pitting edema. The presence of marked swelling of the entire body signifies a severe underlying condition.
Diabetes mellitus is very rampant and as the morbidity rate increases, cases of diabetic nephropathy as one of its complications also increase.
But because these are spilled into the urine, there will be less proteins in the plasma, decreasing the osmotic pressure.
The disease worsens, stimulating neurohumoral excitation, causing sodium retention in the kidneys and expanded plasma volume. If you have edema, the first question to be asked is “Is it localized or generalized?” If it is localized, it may be due to venous obstruction, lymphatic obstruction, or local injury. Thiazides or loop diuretics may be added but giving diuretics should be closely monitored because overuse may backfire to a worse complication like hepatic encephalopathy. In contrast with the word “swelling,” the whole body is grossly edematous and not just a certain part.

If osmotic pressure is low, fluid leaks out or extravasates into the interstitium, hence the edema. In this condition, there is increased capillary permeability and obstructed lymphatic vessels, resulting to extravasation of fluid into the subcutaneous tissue. The most convincing among them is the peripheral arterial vasodilation hypothesis suggesting that ascites is caused by portal hypertension which leads to vasodilation.
So more often than not, there is nothing to worry about as it will subside as the obstruction is removed and as the injury heals.
If anasarca is due to hypoalbuminemia, the patient may either have severe malnutrition, liver cirrhosis, or nephrotic syndrome. Edema can be caused by either systemic diseases (diseases affecting multiple organ systems) or by local conditions involving just the affected extremities. In anasarca, the decreased capillary osmotic pressure is systemic, giving you a generalized edema or swelling. These two affect the glomeruli of the kidneys by increasing the thickness of its basement membrane, causing the glomeruli to enlarge. As the proteins continue to spill into the urine, more nephrons become destroyed, worsening the proteinuria, and the cycle goes on and on until the condition progresses to renal failure.

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