The term swelling means localized enlargement or lump. Although it is an ambiguous and somewhat colloquial definition for the medical world, it is still common to find it in some literature. Its use is also frequent among the general population, who classify many space-occupying injuries as "swellings.".
The word has an etymological origin from Latin tumefactum, impersonal form of swelling, which means "swell" or "tumor." His first descriptions date back a long time; Hippocrates already mentioned swelling in his medical texts, affecting even internal organs such as the spleen and liver..
Swellings have multiple causes: from the genetic to the acquired and from the traumatic to the strictly medical. Some are mild and self-limiting, and others are manifestations of serious illness; the treatment to be applied will depend on the cause and associated symptoms.
Swelling should not be considered synonymous with swelling. Although they share some characteristics, swelling refers to a well-defined lesion in a precise area and swelling can affect large areas, without specific limits, affecting an entire limb and even the entire body (anasarca)..
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Swelling has very particular characteristics depending on its cause, location and possible concomitants. However, it complies with the basic elements of any localized inflammatory process: heat, redness, pain and functional impotence of the organ or apparatus involved..
The increase in local temperature is directly related to the increase in local blood flow. Among its various tasks, the pro-inflammatory substances that are released in the affected area produce vasodilation so that the defensive elements reach the site of injury faster..
Another immediate consequence of vasodilation is the discoloration of the skin. The reddish tone that appears in and around the swelling is achieved by the effects of light on the greater amount of hemoglobin that is circulating there. In addition, there may be small local hemorrhages that promote flushing.
Immediate reaction mediated by pro-inflammatory substances stimulates regional nociceptive receptors and causes pain.
This unpleasant feeling has an important function: to warn that something is wrong and that something must be done about it. In addition, the pain itself stimulates the continuous production and release of required protective elements..
Loss of function in the affected area is the ultimate consequence of swelling. This inability to work will normally depend on the affected area.
The most obvious are swelling in the limbs that can make walking or manual tasks impossible, but internal ones also affect the functioning of some organs..
Swellings can be clinical manifestations of other pathologies. They are often associated with systemic infections, circulatory disorders, immune diseases, or cancer..
When there is the presence of fever, chills, elevated white blood cells and general malaise, a significant infectious picture should be suspected.
Swelling may be the cause or a consequence of this process. This symptomatology can also be associated with autoimmune disorders, so certain discards are necessary..
Circulatory disorders, especially in the lower limbs, can cause swelling. They have a significant blood content and are accompanied by varicose veins, pain, and difficulty walking. If there is chronic weight loss, diffuse pain and asthenia, the presence of an oncological disease is very likely.
The symptoms are usually very guiding when determining the causes of swelling. In etymological terms, the causes can be summarized in two large groups: local diseases and systemic diseases..
Skin lesions are a common cause of subsequent swelling. Wounds, lacerations, abrasions and direct trauma can produce local enlargement with all the usual characteristics of inflammation..
If these lesions become infected, they increase the chances of swelling. In these cases, when bacteria are already present, the swelling fills with pus and surgical procedures are required to drain them and achieve a definitive cure..
Lymphatic and vascular obstructions can also cause swelling. They tend to be increases in volumes with liquid content, soft to the touch, painful on palpation and located mainly in the lower limbs.
Many diseases of varying severity but with global components may have swelling among their symptoms. Among the most important of these are the following:
Septicemia is capable of causing swelling not only in the skin but also in internal organs. Depending on the germ causing the infection and its entry gate, space-occupying lesions can occur in solid viscera such as the liver, spleen, kidneys, lungs, heart and brain..
A particular characteristic of these pathologies is the scattered presence of cutaneous swellings. An example of these cases are the typical nodules of rheumatoid arthritis or dermatomyositis. Internally, amyloidosis and sarcoidosis produce organic lesions compatible with swelling.
Solid tumors can be considered swellings in fact, since they almost always fulfill the basic conditions of an inflammatory process; the latter applies even more so when tumors become infected. Bone or skin cancer is the best example of these cases.
Systemic oncological diseases, including hematological ones, can manifest as swellings in different organs, both solid and hollow. This is common in lymphomas and adenocarcinomas..
Vascular swellings in the lower limbs of patients with circulatory problems are not unusual. The same occurs with lymphatic disorders and, like malignant tumors, if they become infected they can be classified as abscessed swellings..
The therapies to be applied will depend on the origin of the swelling. They can be summarized in medical and surgical treatments.
Antibiotic therapy is the obvious treatment for infectious swellings. Due to the common presence of gram-negative germs, clindamycin and metronidazole are the drugs of choice..
In the case of cancer diseases, chemotherapy and radiotherapy can give good initial results. The use of steroids is indicated when the cause of the swelling is immunological, and if there are circulatory disorders, vasoprotectors, antiphlebitics and capillary stabilizers are the first line treatments..
Drainage of abscessed swellings is essential for healing, in conjunction with antibiotics. The same occurs in the presence of circulatory disorders, with special care if there is vascular compromise.
Certain lesions can be completely removed, which happens a lot in cancer cases. Total excision is not always possible, but it is still a valid therapeutic option, at least to relieve discomfort..
Other local treatments are used with some frequency. Tempered compresses (hot or cold) offer immediate but limited improvement in the symptoms associated with swelling; Antibiotic creams and steroid lotions are indicated to reduce local infectious and inflammatory processes.
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