Résumé
Peripheral oedema is the presence of palpable swelling resulting from increased interstitial fluid in the tissue of the extremities. [1] The most severe, generalised form of oedema is called anasarca. Oedema is caused by imbalance of the equilibrium between the hydrostatic forces that push fluid into the tissue spaces and the oncotic gradient that draws fluid into the intravascular space. [2] Normally, the small amount of net movement of fluid into the interstitial space is removed by lymphatic drainage. If this drainage is obstructed, oedema gradually develops. [3]
The body has a number of homeostatic mechanisms that serve to maintain this balance, and these must be overwhelmed before fluid build-up becomes evident as peripheral oedema. Clues generated by the history, physical examination, and targeted evaluation help to identify the underlying aetiology of peripheral oedema.
Diagnostic différentiel
- Common
- Uncommon
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- Pericardial effusion
- Constrictive pericarditis
- Restrictive cardiomyopathy
- Tricuspid regurgitation
- Sleep apnoea
- May-Thurner syndrome
- Hepatic venous outflow obstruction (includes Budd-Chiari syndrome, portal vein thrombosis, and HVOD)
- Renal failure
- Protein-losing enteropathy
- Angio-oedema
- Sepsis
- Compartment syndrome
- Primary lymphoedema
- Secondary lymphoedema
- Idiopathic
- Severe malnutrition
- Hypothyroidism/myxoedema
- Medicine-induced oedema
- Ruptured Baker's cyst
- Yellow nail syndrome
