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Approach to leg edema

Fulvio Pomero, Roberta Re, Michele Meschi, Domenico Montemurro, Laura Spadafora, Valentina Borretta, Monica Zampogna, Annalisa Marchetti, Mariangela Di Lillo, Daniela Tirotta, Chiara Bozzano, Micaela La Regina, Paola Gnerre
  • Fulvio Pomero
    Internal Medicine Department, S. Croce e Carle Hospital, Cuneo, Italy | fulviopomero@yahoo.it
  • Roberta Re
    Internal Medicine Department, Maggiore della Carità Hospital, Novara, Italy
  • Michele Meschi
    Internal Medicine Department, Santa Maria Hospital, Parma, Italy
  • Domenico Montemurro
    Internal Medicine Department, S. Bortolo Hospital, Vicenza, Italy
  • Laura Spadafora
    Specialty training in Internal Medicine, University of Turin, Italy
  • Valentina Borretta
    Specialty training in Internal Medicine, University of Turin, Italy
  • Monica Zampogna
    Specialty training in Nutrition, University of Padova, Italy
  • Annalisa Marchetti
    Accident and Emergency Department, INRCA, Ancona, Italy
  • Mariangela Di Lillo
    Accident and Emergency Department, Ospedali Riuniti, Marche Nord, Fano (PU), Italy
  • Daniela Tirotta
    Internal Medicine Department, Hospital of Cattolica (RN), Italy
  • Chiara Bozzano
    Accidents and Emergency Department, San Donato Hospital, USL 8, Arezzo, Italy
  • Micaela La Regina
    Internal Medicine Department, Levante Ligure Hospital, ASL 5, La Spezia, Italy
  • Paola Gnerre
    Internal Medicine Department, San Paolo Hospital, Savona, Italy

Abstract

Edema is defined as a palpable swelling caused by an increase in interstitial fluid volume. Leg edema is a common problem with a wide range of possible causes and is the result of an imbalance in the filtration system between the capillary and interstitial spaces. Major causes of edema include venous obstruction, increased capillary permeability and increased plasma volume secondary to sodium and water retention. In both hospital and general practice, the patient with a swollen leg presents a common dilemma in diagnosis and treatment. The cause may be trivial or life-threatening and it is often difficult to determine the clinical pathway. The diagnosis can be narrowed by categorizing the edema according to its duration, distribution (unilateral or bilateral) and accompanying symptoms. This work provides clinically oriented recommendations for the management of leg edema in adults.

Keywords

Edema; internal medicine; differential diagnosis.

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Submitted: 2016-08-27 16:19:21
Published: 2017-09-11 18:20:07
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Copyright (c) 2017 Fulvio Pomero, Roberta Re, Michele Meschi, Domenico Montemurro, Laura Spadafora, Valentina Borretta, Monica Zampogna, Annalisa Marchetti, Mariangela Di Lillo, Daniela Tirotta, Chiara Bozzano, Micaela La Regina, Paola Gnerre

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