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Etiology of the Lesion
Pitting edema is mostly caused by either local conditions including the affected parts or systemic diseases, this means that the diseases affect different body systems. The most often systematic disorders related with pitting edema include the kidneys, liver, and heart, and in these common diseases, pitting edema takes place mainly due to the retention of excess amount of salt in the body. Too much salt (sodium chloride) triggers the body to hold water and this water later enters the interstitial tissue gaps that cause swelling called pitting edema (Williams 565).
Pitting edema is usually caused by heart failure, diabetes, and venous incompetence that bring about heart illness that then result in pitting edema. Pitting edema is only an expression of a general illness and the general local states that bring about pitting edema are thrombophlebitis (inflammation appearing in the veins) and varicose of the interior veins that are found in the legs. These situations may cause insufficient supply of the blood by the veins (venous deficiency) and the following raised back-pressure in the veins of the legs and stresses the fluid to remain in the ankles and feet or other extremities. Too much fluid in these extremities then seeps into the interstitial organs’ gaps and leads to the pitting edema.
Pitting edema can take place during the period of pregnancy since would-be women have a higher amount of fluid flowing in the body tissues and organs, and since they have higher probability to retain more fluid than in the normal days. Pregnant woman may also undergo postpartum edema and the wall of the blood vessel is damaged and may not retain equilibrium required by the body organs.
Macroscopic and Microscopic Findings
Macroscopic results in pitting edema consist of swelling, along with the loss of flexibility of the lungs that are pit of pressure and turns to be paler than the usual state. Too much amount of serous liquid is displayed in the cut area of the lung and usually, collections of fluid exist in the parenchyma and alveoli.
Microscopic findings include the point that in all body organs or tissues are observed severe inflammatory foci and variable amounts of parasitic pseudocysts and the foci contain various eosinophils and in the most commonly and greatly injured body organ. The liver also reports a fatty degeneration or paranchymatous and severe spelenitis is most frequently reported. There is prolonged dent when a thumb is pressed on the surface affected with pitting edema, and the dent will stay for sometime before coming back as usual.
Symptoms, Signs and Lab Findings
The signs and symptoms of pitting edema include fever, dysphagia, distention, jugular vein, and pericardial friction rub. Other symptoms are non productive cough, orthopnea, dyspnea, and pain experienced in the chest (Williams 565). Hypertension can also be experienced by patients with patting edema. When a finger is pressed on the swollen part of the body of a person with pitting edema, the finger leaves am imprint. Pathogens are not reported after examining the stool and throat and there is negativity of both urine and blood components. The tests taken from synovial fluid from the joints of the knee reported reduction in leukocyte count and viscosity that contain alot of lymphocytes. There is normality in the roentgenograms of the hips, hands, shoulders, ankles, and knees. These symptoms and laboratory results report that the patient is experiencing pitting edema. Pitting edema takes place after the fluid leaks into the tissues and if you press a thumb on the region experiencing pitting edema for some time, the dent will created and this dent disappears after some time. The dent remains for some minutes and this differentiates between pitting and non-pitting edema.
The laboratory findings include Hemoglobin 9.9 g/dl, 4% of eosinophilis, leucyte count 10, 300, and 10% of lymphytes. Urinalysis reports 2-3 leukocytes and 7-8 erythrocytes in every high-power area and the rate of erythrocytes sedimentation are 115mm per hour. There is slightly elevation of complement elements and the results of the anti-nuclear antibodies, anti-dsDNA, and serum IgM reheumatoid factor are always found to be negative. There are findings of below 200 Todd units of sertum anti-streptolysm-O titer and positivity of the C-reactive protein that is found to be 192mg/L (Sussman and Bates-Jensen 56).
Treatment and Prognosis
The doctor examines the condition of the affected area to identify if it can be shiny or stretched. The most appropriate approach to treat pitting edema is use of massage before it becomes more severe (Howle 127). Approaches like frequent exercise, air splints, Jobst gloves, appropriate massage, and supported elevation are examples of the interventions that should be carried out to control pitting edema. Compression stockings are also applicable to this disorder. The treatment for edema includes undertaking an intervention on the basic condition of the disorder, limiting the quantities of the salt consumed, and frequently using diuretics, these are drugs that are used to induce urination.
Relying on the causes of the pitting edema and if it is critical or temporary, curing this disorder commonly concentrates on treating the disease that facilitate pitting edema. The patient may be provided with a low dose of prescribed medicine (water pill) to help decrease the swelling and reduce too much fluid around the affected area. However, it is very vital to understand that this procedure only treat the symptoms and is not essentially solving the cause of pitting edema (Sussman and Bates-Jensen 56).
If it is observed that the cause of the pitting edema is a damaged or blocked vessel, surgery can be recommended to allow the flow of blood in the veins. Use of blood thinners can also be recommended to solve blood clots that can triggers pitting edema. As the blood clots start to disappear, fluid drainage helps recover and swelling, therefore, begins to disappear as well. Edema treatment should contain safeguarding the regions that are swollen, edematous regions of the organ from damage, injury, severe temperatures, and pressure. The skin that experience edema turns out to be fragile eventually. Cuts, burns, and scrapes are regions of the body that experience pitting edema experience much longer time to recover and are vulnerable to any infection.
Relevance to Dental Practice
Edema of the body organs takes place because of insufficient dental practices and hygiene. Some dental procedures should be taken and application of ice cubes is one major way to ease the pain. Edema often appears after dental procedures and cold compress on the affected areas of the body on the first day after recognizing the symptoms. Infections always spread through bacteria that remain in the affected part of the body organ and dental procedures should be followed to remove all the bacteria that are eligible to cause severe edema in the body.
Howle, Janet. Neuro-developmental Treatment Approach: Theoretical Foundations and Principles of Clinical Practice. Laguna Beach, CA: NeuroDevelopmental Treatment, 2002. Print.
Sussman, Carrie and Barbara Bates-Jensen. Wound Care: A Collaborative Practice Manual for Health Professionals. London: Lippincott Williams & Wilkins, 2006. Print.
Williams, Lippincott. Nurse’s Rapid Reference. Washington, DC: Lippincott Williams & Wilkins, 2008. Print.