Dropsy
The content of the article:
- Causes
- Kinds
-
Signs of dropsy
- Dropsy of the testicle
- Dropsy of the gallbladder
- Dropsy of pregnant women
- Dropsy of the fetus
- Diagnostics
- Dropsy treatment
- Prevention
Edema (watery edema) is a pathological process, which is based on the accumulation of transudate in the interstitial space or subcutaneous tissue. Dropsy is not an independent disease, it is one of the symptoms characteristic of pathologies of the kidneys, heart, liver, endocrine glands.
Dropsy of the abdomen
Causes
The most common causes of dropsy in children and adults are:
- dysfunction of the central nervous system (neuropathic dropsy);
- venous insufficiency;
- violation of lymph outflow;
- violations of the physico-chemical composition of blood and / or lymph;
- cirrhosis of the liver;
- congenital and acquired heart defects;
- groin trauma (one of the main causes of the local form of dropsy in men and boys).
The pathological mechanism is based on an imbalance between the inflow and outflow of interstitial fluid. Normally, through the wall of blood capillaries, there is a constant sweating of the liquid part of the blood into the interstitial space. This phenomenon is called transudation. In those cases when the backflow of fluid from the tissues into the circulatory system becomes less than its exit from the capillaries, tissue edema develops, that is, dropsy.
Kinds
Depending on the location of the edema:
- dropsy of the abdomen (abdominal dropsy, ascites);
- dropsy of pregnant women;
- dropsy of the fetus (immune and non-immune form);
- dropsy of the eye (hydrophthalmos);
- dropsy chest (hydrothorax);
- dropsy of the brain (hydrocephalus);
- dropsy of the heart (dropsy of the pericardium, hydropericardium);
- dropsy of the testicle (dropsy of the testicular membranes, hydrocele);
- dropsy of the joints (hydrarthrosis);
- dropsy of the spermatic cord (funicocele, congenital cyst of the spermatic cord);
- dropsy of the gallbladder;
- dropsy of the fallopian tubes (hydrosalpinx);
- dropsy of the ovary (serous ovarian cystoma);
- dropsy of the kidney (hydronephrosis);
- dropsy of the lacrimal sac.
Pericarditis or dropsy of the heart
Signs of dropsy
The clinical manifestations of dropsy are determined by the type of pathology.
Dropsy of the testicle
Dropsy of the testicle (dropsy of the testicular membranes, hydrocele) is an accumulation of transudate in the space between the visceral and parietal layers of the testicle's own membrane. The volume of the liquid usually ranges from 20 to 200 ml. In rare cases, it can reach several liters. The main symptom of dropsy of the testicle is an enlargement of the corresponding half of the scrotum.
Types of testicular dropsy or hydrocele
Dropsy of the gallbladder
Dropsy of the gallbladder is a pathological condition that develops against the background of a number of diseases of the hepatobiliary system and is characterized by the accumulation of non-inflammatory fluid in the gallbladder cavity. This pathology is often preceded by attacks of hepatic colic. With a slight increase in size, the watery gallbladder may not manifest itself clinically. Further accumulation of fluid in it becomes the cause of pain in the liver. The pain is dull, aching in nature, it can radiate to the back, shoulder, right shoulder blade.
The gallbladder with dropsy is palpable as a painless densely elastic formation of a round shape, located under the lower edge of the liver.
Dropsy of pregnant women
Dropsy of pregnant women is one of the manifestations of OPG-gestosis (late toxicosis of pregnant women), which develops against the background of violations of water and electrolyte metabolism. This pathology begins to develop from the second half of gestation. In the initial stage, edema is latent and visually invisible. They can be identified with regular weighing of a pregnant woman on the basis of an excessively rapid increase in body weight (over 300 g in 7 days). If the necessary treatment for dropsy of pregnant women is not available at this stage, the edema spreads throughout the body.
Dropsy of pregnant women begins to appear from the second half of gestation
Other symptoms of dropsy during pregnancy:
- increased thirst;
- decreased urine output;
- glossiness of the skin;
- tachycardia;
- tachypnea;
- general weakness.
Dropsy of the fetus
Fetal dropsy is a pathological condition that occurs during intrauterine development and is manifested by the development of generalized edema of the soft tissues of the fetus, as well as the accumulation of transudate in the pericardial cavity, abdominal and chest cavities.
Depending on the cause, dropsy of the fetus is divided into two types:
- immune - a variant of the course of hemolytic disease of the newborn (edematous form);
- non-immune form - develops against the background of various pathological conditions: pregnancy pathologies, various dysplasias, TORCH infections, chromosomal and genomic mutations, congenital heart defects. This form of fetal dropsy is almost always fatal in the first days of a newborn's life.
With dropsy of the fetus, the condition of the newborn is usually assessed as very severe. Due to the significant increase in the cerebral part of the skull, which is associated with hydrocephalus, the head becomes disproportionately large. Due to the pronounced weakness of the skeletal muscles, the child takes the frog pose. In girls, with dropsy of the fetus, underdevelopment of the labia majora is noted, and in boys, cryptorchidism. In many cases, fetal dropsy is accompanied by marked enlargement of the liver and spleen (hepatosplenomegaly).
Diagnostics
The diagnosis of dropsy in itself does not cause difficulty and is based on characteristic clinical signs. It is much more difficult to establish the cause of the edema.
If you suspect dropsy of pregnant women, weight gain is monitored by a woman. Normally, weight gain per week should not exceed 300 g. In addition, daily diuresis is monitored. A decrease in the daily amount of urine with an increase in nocturnal urine output is a characteristic sign of dropsy in pregnant women.
If you suspect dropsy in pregnant women, it is important to control the woman's weight
The most informative for dropsy of the gallbladder are instrumental diagnostic methods:
- plain x-ray of the abdominal cavity (rounded shadow from an enlarged gallbladder);
- retrograde cholangiopancreatography or cholecystography (contrast agent does not enter the cavity of the gallbladder, but accumulates in the hepatic and bile ducts);
- Ultrasound of the liver and gallbladder;
- magnetic resonance imaging of the abdominal organs;
- computed tomography of the biliary tract;
- diagnostic laparoscopy.
Diagnosis of dropsy of the testicle is carried out on the data of ultrasound examination of the scrotum and diaphanoscopy.
With dropsy of the fetus, the main role in the diagnosis is played by ultrasound. This method allows you to identify pathology at the antenatal stage based on the following signs:
- Buddha pose;
- swelling of the subcutaneous tissue;
- hepatosplenomegaly;
- the presence of free fluid in the cavities of the fetal body;
- polyhydramnios;
- swelling of the placenta.
Dropsy of the fetus is diagnosed using ultrasound
It is difficult to identify the reasons that led to the development of dropsy of the fetus. In this case, a thorough laboratory and instrumental examination of the newborn is carried out:
- serodiagnostics (PCR, ELISA) in order to identify a possible infection;
- determination of blood and Rh in a child and mother with suspected edematous form of hemolytic disease of newborns;
- general and biochemical blood test to assess the function of internal organs, metabolism.
After the birth of a child with dropsy, ultrasound is performed to identify ascites, hydrothorax, hydropericardium, and to evaluate the treatment. If necessary, other diagnostic methods are used, for example, magnetic resonance imaging or computed tomography, ECG, EchoCG.
Dropsy treatment
The choice of a method of treatment for dropsy depends on its type, as well as the causes that caused it, and primarily consists in the treatment of the underlying disease.
With dropsy, pregnant women are advised to follow the water regime and adhere to a balanced diet. The diet must contain foods rich in protein (fish, cottage cheese, lean meat), fresh vegetables and fruits. Significantly limit the use of table salt. If necessary, medication is prescribed (antispasmodics, sedatives and antihistamines). The appointment of diuretics for dropsy of pregnant women is undesirable, since their intake can further enhance the existing violations of the water-electrolyte balance. With significant edema, there are indications for hospitalization of a woman in the department of pathology of pregnant women.
With dropsy of the gallbladder, the main method of treatment is its surgical removal (cholecystectomy).
To date, there are no effective methods of therapy for the non-immune form of dropsy of the fetus. Immediately after birth, the child needs intensive care (erythrocyte transfusion, tracheal intubation and transfer to artificial ventilation, laparocentesis, pericardial or thoracic puncture). According to indications, anticonvulsant, metabolic, immunocorrective, antibacterial or antihemorrhagic therapy is performed.
With dropsy of the gallbladder, removal of the organ is indicated
Treatment of the immune form of dropsy of the fetus begins before birth. Under ultrasound control, the doctor punctures the umbilical cord vein of the fetus through the anterior abdominal wall of the pregnant woman and installs a catheter into it. Through it, up to 50 ml of Rh-negative blood of the same group as the fetal blood is transfused. In cases where the fetal blood group cannot be established, transfusion of Rh-negative blood of group I (0) is performed.
Treatment of dropsy of the testicle begins with conservative methods (wearing a suspensory, rest, the introduction of sclerosing agents into the cavity of the hydrocele). If therapy is ineffective, surgical intervention is indicated. There are different methods of operations for dropsy of the testicle (according to Ross, Bergman and Winckelmann).
Prevention
The prevention of dropsy is aimed at preventing diseases, pathologies and injuries, accompanied by the development of watery edema. For example, the prevention of dropsy of the gallbladder is based on the timely diagnosis and active treatment of diseases of the hepatobiliary system.
Specific preventive measures have been developed only for the immune form of fetal dropsy. They consist in the use of anti-rhesus immunoglobulin, which destroys the Rh-positive erythrocytes of the fetus, which could enter the mother's blood. As a result, isoimmunization of the woman is prevented, and thereby the likelihood of developing hemolytic disease of the newborn is reduced.
Anti-Rh immunoglobulin administration should be given to all women with Rh negative blood within 72 hours after:
- induced or spontaneous abortion;
- childbirth;
- surgical intervention for ectopic pregnancy;
- transfusion of Rh-positive platelet or erythrocyte mass.
Also, injections of anti-rhesus immunoglobulin are indicated for pregnant women belonging to the risk group for hemolytic disease of the newborn.
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Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
