Turkish Journal of Geriatrics 2004 , Vol 7, Issue 2
Süleyman Demirel Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Anabilim Dalı, ISPARTA
Türkiye Yüksek İhtisas Hastanesi, Kalp ve Damar Cerrahisi Kliniği, ANKARA
Edema in the lower limb of elderly patients is a common problem. Clinical examination of the elderly patients frequently reveals correct cause of lower limb edema. Diagnosis of the leg edema in elderly population requires consideration of whether the edema is acute or chronic, bilateral or unilateral, localized or generalized, and painless or painful. Chronic and unilateral edema usually arises from venous or lymphatic disease, whereas bilateral edema always indicates a systemic or central cause, such as cardiac, renal and liver diseases, malnutrition and thyroid disorder.
Initial laboratory examinations should include routine blood tests and urinalysis to look for signs of systemic diseases. Once a systemic cause of edema is excluded, the regional causes should be investigated. Doppler examination is usually sufficient to diagnose venous diseases. The main vascular causes of a leg edema in elderly population are deep venous thrombosis (DVT), chronic venous insufficiency, superficial thrombophlebitis, varicose veins, and acquired arteriovenous fistulas. DVT usually presents with painful leg edema. Therefore venous insufficiency is always secondary to a previous DVT. Superficial thrombophlebitis is associated with intravenous catheters or intravenous drug use in the lower extremities. Varicose veins are commonly divided primary varicose vein, in which the deep venous system normal, and secondary varicose vein, in which the deep venous system is incompetent.
Besides, lymphedema may also be difficult to differentiate from vascular causes.
In present article, we reviewed the common causes of leg edema based on vascular topics in elderly population.
Keywords : Edema; Lower limb; Elderly; Geriatrics.