Oedema, also called hydrops, results from an accumulation of excess fluid in the interstitial spaces or body cavities due to diseases rather than being a disease itself. It can be generalized affecting the entire body or localized to certain areas. The causes of oedema include problems with the veins, heart, liver, kidneys, lymphatics, hormones, nutrition, and inflammation which increase hydrostatic pressure, decrease plasma oncotic pressure, obstruct lymphatic drainage, or cause sodium and water retention leading to excess fluid build up.

1. OEDEMA

2. DEFINITION
• Oedema results from the
accumulation of excess fluid in the
interstitial spaces or serous
cavities.
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3. • Edema: is the accumulation of excessive body fluid in
interstitial space or serous body cavity, which is a
pathologic process caused by diseases rather than a
disease entity.
• Hydrops: when body fluid is accumulated in serous body
cavity, edema is also called hydrops, such as ascites and
hydrothorax.

4. TYPE
• According to the range that edema fluid spreads to:
– Anasarca (generalized edema)
– Local edema
• According to the cause of edema:
– Renal edema
– Hepatic edema
– Cardiac edema
– Malnutritional edema
– lymphedema

5. 1) According to pathophysiological mechanism:
a) Transudate (low protein content)
b) Exudate (high protein content)
3) According to clinical finding:
a) Pitting
b) Non-pitting.

6. CAUSE
• THE LEAK OF VEINS
Tumor
Heart failure
Enteropathy (protein-losing)

7. .
Liver failure
Endocrine (hypothyroidism, aldosterones,diabetes)
Altitude sickness
Kidney disease (renal failure, nephrotic syndrome)
Obstruction of lymphatics
Filariasis
Venous thrombosis
Eclampsia / pregnancy
Iatrogenic
Nutritional deficiency
Sepsis / capillary leakage
Mnemonics)
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8. Mechanism of Action of Oedema

9. 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

10. 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

11. 3. Lymphatic Obstruction
Impaired lymphatic drainage
Localised Lymph OEDEMA
 Radial mastectomy for Ca breast
 Pressure on main lymph ducts
 Inflammation of lymphatics
 Occlusion of Lymphatics by malignant cells

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

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