edéma

Edema, or edema (edéma in some languages), is swelling caused by the accumulation of excess fluid in the interstitial tissue. It most commonly affects the feet, ankles, and legs but can involve any part of the body. Edema may be mild or extensive and can be a temporary response to heat, standing, or injury, or a sign of a chronic condition.

Edema results from an imbalance in fluid movement between capillaries and surrounding tissues. Factors include increased hydrostatic pressure (as in heart failure or venous insufficiency), reduced plasma oncotic pressure (as in liver disease or malnutrition), lymphatic obstruction, and increased capillary permeability (inflammation). It is often categorized by distribution (local vs generalized) and by mechanism (pitting versus non-pitting). Systemic edema can reflect cardiovascular, renal, hepatic, or endocrine disorders, while localized edema may arise from injury, infection, or inflammation. Medications such as calcium channel blockers and nonsteroidal anti-inflammatory drugs can contribute.

Evaluation starts with history and physical examination to determine onset, symmetry, and associated symptoms. Red flags include sudden unilateral leg swelling with pain (possible deep vein thrombosis), shortness of breath, chest pain, or rapid weight gain. Diagnostic workup may include blood tests (kidney and liver function, albumin, electrolytes), urinalysis, imaging (ultrasound for DVT, echocardiography for heart failure), and chest imaging or BNP measurement as indicated.

Treatment focuses on the underlying cause. Nonpharmacologic measures like leg elevation and compression stockings can help mild edema. Dietary salt restriction and overall fluid management are used in some conditions. Diuretics may be beneficial for certain etiologies under medical supervision. Long-term edema control also involves treating the root disease and monitoring for skin changes or ulcers. Prognosis depends on the underlying condition and its reversibility.