Differential diagnosis and treatment edema. Tactics gp

Edema occurring in renal diseases
Formation of edema accompanied by a decrease of diuresis (urine daily amount of 500 ml or less).
- Body weight increased in a short time.
- Swelling appear in the morning and go throughout the day.
- Swelling of the subcutaneous tissue is initially limited, local, later (sometimes rapidly) takes prevalent edema (anasarca).
- Significant swelling of the face of the beginning (around the eyes, eyelids, cheeks, etc.) and distribute it to the trunk and limbs.
- Observed accumulation of fluid in the cavities, often hydrothorax and rarely ascites.
-Often occurs swelling of internal organs (heart, liver, lungs, brain), which can create a clinical picture depending on the location.
- Is characterized by rapid appearance of edema and also pretty fast disappearance.
- Swelling skin is pale, normal temperature.- Consistency swelling soft, pasty.
- For large swelling are signs of degeneration of the skin and its appendages: dryness, sometimes shiny, atrophic, epidermis peeling, brittle, dull hair and nails.
- Swelling quickly shift with a change in body position.
- Leave a hole when pressed with your finger that quickly returns to its original position.
- In most cases, shortness of breath, as a rule, does not arise. The liver was not enlarged.
Swelling in liver diseases.
Swelling caused by hypoalbuminemia in liver disease, can occur in advanced stages of the severe liver disease (chronic hepatitis, cirrhosis) in patients with severe liver albuminsinteziruyuschey abuse. Often for liver dominates ascitic syndrome (often in combination with right hydrothorax).
Swelling of hepatic origin.
- History reveals transferred viral hepatitis, alcoholism, toxic effects;
- No expression of a violation of the heart and kidneys;- Identify the symptoms of chronic liver disease (cirrhosis) arterial spider hemangioma, liver palm (erythema), gynecomastia, and venous collaterals on the anterior abdominal wall;
- Swelling localized mainly in the abdominal cavity with the formation of ascites.
- Swelling of the legs are attached relatively rare;- Occur without clinical signs of the small amount of liquid;
As the amount of fluid observed abdominal distension, discomfort, anorexia, nausea, heartburn, pain in the right upper quadrant, and respiratory disorders. Swelling or bulging sides of abdomen;
- Symptom ruffling or "splashing" on auscultation;
- Shortening of percussion sound in the side of the abdomen with a change of position of the patient or the appearance of dullness in the center of the abdomen with the knee-elbow position the patient.
- Ascites may be associated with swelling of the vulva, umbilical or inguinal hernia, pleural effusion, often sided.In the blood, change in the amount of bilirubin, enzymes.