Lower Extremity Edema and Leaking Legs

19nov6

November 5, 2019 – I visited a friend in a hospital.  He told me he has lower extremity edema or pedal (leg and foot) edema with fluid actually oozing out and seen on the skin of the leg surface.

I told him you are the third or fifth patient that I have personally encountered with leaky legs associated with lower extremity edema.

Today, November 6, 2019, I went back to my files and tried to retrieve pictures of my personal experience.  Got them and will share.

2012

First one, I think, was in 2012.  A male patient with malignancy in the abdomen with ascites and extensive edema of the lower legs.  I suspected the edema was due to the malignancy in the abdomen causing obstruction of big blood vessels in the abdomen preventing circulation of the lymph up to the upper body or heart.

I took pictures of this patient’s legs showing the swollen legs and leaking fluid.  He eventually died of the malignancy.

2015

An elderly female about 90 years old with swollen lower extremity oozing fluid. She underwent acupuncture for this with increased protein intake. The leaky legs disappeared after about 5 to 6 months.

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November 2015

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dOPPLER

November 2015

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February 2016 – leaky legs subsiding after acupuncture and high protein diet.

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November 2015 – leaky legs subsiding after acupuncture and high protein diet.

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February 2016 – leaky legs subsiding after acupuncture and high protein diet.

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February 2016 – leaky legs subsiding after acupuncture and high protein diet.

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April 2016 – no more leaky legs (6 months after).




Excerpts from Internet:

How do wet and edematous legs develop?

The body naturally allows fluid to leak from the blood vessels into the surrounding tissue as a means of transportation from blood to cells.  Most of the fluid (about 90%) is
reabsorbed back into the capillaries, while the remainder is absorbed by the lymphatic system (World Union of Wound Healing Societies [WUWHS], 2007).

There is a fine balance between the fluid leaking from the capillaries and the fluid being reabsorbed back into the capillaries and lymphatic system. When there is a change in the volume of fluid leaking or being reabsorbed, an imbalance occurs, and this may eventually lead to swollen, oedematous legs that can start to leak outside the body. Identifying the cause of this change is important to resolving the oedematous, wet legs.

This article considers the use of superabsorbent dressings, compression bandages, skin care and barrier creams to improve care.

file:///C:/Users/rojoson/Downloads/the-causes-and-treatment-of-wet-weeping-legs.pdf

[PDF] The causes and treatment of wet weeping legs – Wounds UK

https://www.wounds-uk.com › download › resource

 




https://www.webmd.com/heart-disease/heart-failure/edema-overview#1

EDEMA 

Edema happens when your small blood vessels leak fluid into nearby tissues. That extra fluid builds up, which makes the tissue swell. It can happen almost anywhere in the body.

Types of Edema

Peripheral edema. This usually affects the legs, feet, and ankles, but it can also happen in the arms. It could be a sign of problems with your circulatory system, lymph nodes, or kidneys.

Pedal edema. This happens when fluid gathers in your feet and lower legs. It’s more common if you’re older or pregnant. It can make it harder to move around in part because you may not have as much feeling in your feet.

Lymphedema. This swelling in the arms and legs is most often caused by damage to your lymph nodes, tissues that help filter germs and waste from your body. The damage may be the result of cancer treatments like surgery and radiation. The cancer itself can also block lymph nodes and lead to fluid buildup.

Pulmonary edema. When fluid collects in the air sacs in your lungs, you have pulmonary edema. That makes it hard for you to breathe, and it’s worse when you lie down. You may have a fast heartbeat, feel suffocated, and cough up a foamy spittle, sometimes with blood.

Cerebral edema. This is a very serious condition in which fluid builds up in the brain. It can happen if you hit your head hard, if a blood vessel gets blocked or bursts, or you have a tumor or allergic reaction.

Macular edema. This happens when fluid builds up in a part of your eye called the macula, which is in the center of the retina, the light-sensitive tissue at the back of the eye. It happens when damaged blood vessels in the retina leak fluid into the area.


Possible causes of edema:

Low albumin. Your doctor may call this hypoalbuminemia. Albumin and other proteins in the blood act like sponges to keep fluid in your blood vessels. Low albumin may contribute to edema, but it’s not usually the only cause.

Allergic reactions. Edema is a part of most allergic reactions. In response to the allergen, nearby blood vessels leak fluid into the affected area.

Obstruction of flow. If drainage of fluid from a part of your body is blocked, fluid can back up. A blood clot in the deep veins of your leg can cause leg edema. A tumor blocking the flow of blood or another fluid called lymph can cause edema.

Critical illness. Burns, life-threatening infections, or other critical illnesses can cause a reaction that allows fluid to leak into tissues almost everywhere. This can cause edema all over your body.

Congestive heart failure. When the heart weakens and pumps blood less effectively, fluid can slowly build up, creating leg edema. If fluid builds up quickly, you can get fluid in the lungs. If your heart failure is on the right side of your heart, edema can develop in the abdomen.

Liverdisease. Severe liver disease, such as cirrhosis, causes you to retain fluid. Cirrhosis also leads to low levels of albumin and other proteins in your blood. Fluid leaks into the abdomen and can also cause leg edema.

Kidney disease. A kidney condition called nephrotic syndrome can cause severe leg edema and sometimes whole-body edema.

Pregnancy. Mild leg edema is common during pregnancy. But serious complications of pregnancy like deep vein thrombosis and preeclampsia can also cause edema.

Head trauma, low blood sodium (called hyponatremia), high altitudes, brain tumors, and a block in fluid drainage in the brain (known as hydrocephalus) can cause cerebral edema. So can headaches, confusion, unconsciousness, and coma.

Medications. Many medicines can cause edema, including:

CANCER can also cause edema.


TREATMENT

Edema from a block in fluid drainage can sometimes be treated by getting the drainage flowing again. A blood clot in the leg is treated with blood thinners. They break down the clot and get drainage back to normal. A tumor that blocks blood or lymph can sometimes be shrunk or removed with surgery, chemotherapy, or radiation.

Leg edema related to congestive heart failure or liver disease can be treated with a diuretic (sometimes called a ”water pill”) like furosemide (Lasix). When you can pee more, fluid from the legs can flow back into the blood. Limiting how much sodium you eat can also help.






Ascites and Edema

Ascites is the abnormal accumulation of fluid in the peritoneal cavity.

Ascites can be considered as a subtype of edema (abnormal accumulation of fluid anywhere in the body).





Ascites

Ascites is an abnormal buildup of fluid in the abdomen, specifically the . It occurs when the body makes more fluid than it can remove. Ascites can occur with cancer and other conditions. When ascites is due to cancer, or if the fluid in the abdomen contains cancer cells, it is often called malignant ascites or malignant peritoneal effusion.

Causes

People with cancer can develop ascites for different reasons. It may be caused by:

  • cancer cells that spread to and irritate the thin membrane that lines the inner wall of the abdomen (called the peritoneum)
  • tumours that block the  so lymph fluid can’t flow properly
  • the liver not making enough protein (albumin), which may upset the body’s fluid balance
  • cancer cells that block blood flow through the liver

Ascites develops most often with ovarian, uterine (endometrial), cervical, colorectal, stomach (gastric), pancreatic or primary liver cancers. Cancer that spreads to the liver can also cause ascites.

https://www.cancer.ca/en/cancer-information/diagnosis-and-treatment/managing-side-effects/ascites/?region=on




Lymphedema vs Edema

Lymphedema vs Edema

 

          EDEMA     LYMPHEDEMA
Edema is the body’s normal response to an injury such as a sprain. As healing progresses, the excess fluid leaves the area and the swelling goes down. Lymphedema is condition that occurs when the lymphatic system is impaired to the extent that the amount of lymphatic fluid within a given area exceeds the capacity of the lymphatic transport system to remove it.
Edema is usually caused by excess tissue fluid that had not yet returned to the circulatory system. Lymphedema is swelling caused by excess protein-rich lymph trapped within the tissues.
Edema due to an injury, such as bumping into something, is caused by additional tissue fluid coming into the area to help with healing. Lymphedema  impaired tissues respond to injury with slow healing and/or a potentially serious infection.
Edema is also caused by circulatory system problems, such as chronic venous insufficiency, and this swelling usually occurs in the lower areas of the body. Lymphedema  is caused by damage to the lymphatic system and this swelling occurs near the affected area.
Edema swelling does not leave a mark when a finger is pressed into it. This is known as nonpitting edema. Lymphedema  swelling leaves a mark when a finger is pressed into it. This is known as pitting edema. This occurs only in the early stages of lymphedema.
Edema due to some causes can be relieved with diuretics. Lymphedema is harmed, not helped, by treatment with diuretics.

Pedal edema is the accumulation of fluid in the feet and lower legs.


ROJ@19nov6

 

 

 

 

 

 

 

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