A detailed study of the causes of facial swelling. A child has facial swelling: what to do?

Sometimes children, even those who are absolutely healthy at first glance, have swollen eyelids. Panic on the part of parents in such cases is usually not observed: well, you never know, a mosquito bit you right in the eye or drank too much water before bed! If this is the reason, then swelling under the eye baby will pass quickly, but there are different types of swelling, and some of them may indicate serious problems oh with the baby's health..

Causes of swelling under the eye in children

There are so many factors for the development of eyelid edema that we divided them into two conditional groups: physiological and pathological.

The first include:

1. Swelling of the eyelids in newborns. During childbirth, the baby's head is subjected to enormous stress, which sometimes leads to temporary circulatory problems. This causes the development of swelling of the eyes, which usually goes away after a few months.
2. Heredity. Find out if your child’s close relatives also had “puffy” eyelids in childhood. If so, then we are talking about genetic predisposition and there is nothing to worry about. If doubts do not leave parents alone, it is worth showing the child to a pediatrician and ophthalmologist.
3. Eating over-salted food. Excess salt in a child’s diet leads to the development of edema, which indicates fluid retention in the body.
4. Overwork. If the child sleeps too little or, conversely, too much, perform homework at poor lighting, does not leave the computer and TV, is rarely on fresh air- all this will sooner or later affect his face. This is quite natural causes, as a result of which red circles and swelling appear under the child’s eye.
5. Prolonged crying. If the child spends a long time and hysterically, swelling under the eyes may be observed the next morning.

If the swelling goes away on its own on the same day or the next morning, then you can forget about the problem. But if such a story repeats itself every day, it’s worth taking care proper nutrition and the child’s daily routine. If he sits for days on end, with his head buried in his phone or tablet, while crunching chips and washing it all down sweet soda, then here you have swelling of the eyes in the morning. No kidneys can cope with such loads.

If a child complains of pain in the eyes, swelling is accompanied by burning and redness, or has a fever, then it is necessary to immediately consult a doctor. Perhaps the swelling is caused by an inflammatory process, and delay can lead to serious complications with the child’s health.

Now let's look at the most common ones on the site pathological causes swelling under a child's eye:

• Spicy . Often leads to redness and swelling of the lower and upper eyelid. Without treatment, the infection can spread to the healthy eye, which also becomes swollen. Swelling is most pronounced in the first days of the disease. If you move the edge of the eyelid, you will notice that the conjunctiva is hyperemic.
• Hay fever or hay fever. This allergic disease caused by plant pollen. One of the signs of seasonal allergic reaction is conjunctivitis. The eyes become watery and swollen, the conjunctiva becomes bright red, and blood vessels. In this case, the child complains of a runny nose, itching and burning in the eye area.
• Allergy to insect bites. If the bite is on the cheek, forehead or nose, the swelling will quickly spread to nearby tissues, including the eyelids. More often, unilateral swelling is observed, but when bitten on the forehead, the swelling descends to both eyes. The bite site is noticeable, the skin in this area is hot to the touch and itchy.
• Quincke's edema. This is the most dangerous manifestation an allergic reaction to any irritant. It develops rapidly, sometimes a few minutes are enough for the eyes to completely swell to such an extent that the child cannot open them. The skin color remains unchanged, fluid may involuntarily leak from the nose and eyes, and breathing is difficult.
• Barley (hordeolum). The process of accumulation of pus in sebaceous gland or hair follicle can also cause swelling of the eyelids, this is especially noticeable in the internal form of the disease. Blepharitis and chalazion also begin with this symptom.
• Abscess of the century. When the inflammatory process is active in the tissues of the upper or lower eyelid, pus may accumulate. There is significant swelling and redness under the child’s eye or above it, depending on the location of the inflammation. The skin at the site of the abscess is hot and painful. Sometimes the eyes become so swollen that the child cannot open them.
• Phlegmon of the orbit. Inflammatory process in the retina of the eye with the accumulation of purulent masses is often a complication after other eye infections and wounds - conjunctivitis, barley, exposure to foreign body. Rhinosinusitis can also cause the development of this type of disease. One of the symptoms is swelling of the child's eyes.
• Adenoids. When the nasopharyngeal tonsils are enlarged, which is quite often observed in children, this leads to breathing problems. As a result, the face becomes swollen, and the child tries to compensate for the lack of oxygen by inhaling through the mouth.
• Kidney pathologies. Swelling in the morning without itching or burning, when the skin of the eyes remains unchanged, may indicate problems with the urinary system. Swelling is usually bilateral, but sometimes one eye may swell more on the side on which the child slept at night.

Among other things, swelling of the eyes in a child can be observed due to impaired metabolism and intracranial pressure. Stagnation venous blood and lymph in the eye area become the culprits for the appearance of bags under them.

What to do if a child's eyes are swollen?

Regardless of what causes the swelling of the eyelids, the child should be shown to a pediatrician and an ophthalmologist. If they are not related to violations in children's body, parents should reduce the amount of salt in the child’s diet, give less liquid before bed and reduce the time spent watching cartoons and programs.

In case of allergies, the doctor will definitely prescribe sorbents to remove toxins from the body ( Activated carbon, Polysorb, Enterosgel), as well as antihistamines to relieve itching and redness (Fenistil, Zyrtec, Tavegil drops).

If the eyelids rapidly swell, and fluid is involuntarily released from the nose and eyes, then you need to urgently call an ambulance - Quincke's edema is possible.

If a foreign body gets into the eye, the tissue may be damaged, so the doctor will prescribe medications that quickly heal and eliminate dry eyes (Vitasik, Balarpan).

For diseases of an infectious nature, antibacterial therapy is necessary - Tsipromed, Tetracycline or Erythromycin ointment.

If the cause of the swelling is stye, it is forbidden to squeeze it out, heat it or wipe it with alcohol. The disease is caused by a weakened immune system, so the ophthalmologist may prescribe a course of immunostimulants (Arbidol, Immunal, Oscillococcinum).

When the cause of edema lies in diseases of the kidneys and urinary system, impaired metabolism or intracranial pressure, undergoing full course treatment.

If your child has facial swelling, make sure that the child's facial swelling is not due to an allergic reaction. In case of allergies, you need to give the child antihistamines and call an ambulance.

Facial swelling in a large percentage of adults – common occurrence caused by poor nutrition, fatigue or alcohol abuse. Another thing is for children - swelling of the face occurs for more serious reasons.

Causes of facial swelling in children

Rapidly occurring swelling of the face with difficulty breathing indicates an allergic nature of the swelling; such swelling is very life-threatening, as it can swell Airways. Swelling of the face also occurs in a child with acute renal inflammation; in this disease, swelling develops slowly, over the course of a week. Facial swelling may also occur when diabetes mellitus, when eating salty foods or eating large quantity water. Unilateral facial swelling – cheek swelling may occur when purulent inflammation tooth Also, a kind of swelling of the face occurs with mumps.

In the case of rapidly developing allergic edema In a child, it is necessary, if possible, to determine the allergen and isolate the child from it, then give the child antihistamines and call an ambulance.

If a child’s face has become swollen for several days, the temperature is elevated and the child is lethargic, then this may be inflammation of the kidneys, in which case you should urgently consult a doctor and get tested. necessary tests. If you have gumboil, you should take your child to the dentist.

If swelling occurs after eating new dishes or food products, you need to carefully analyze their composition and in the future protect the child from the preservatives and dyes contained in these products. In general, for any swelling, it is better to take the child to the clinic or call a doctor at home. Depending on the cause of the swelling, the doctor will prescribe treatment and the swelling will go away by itself after eliminating its original cause.

Edema in children.
Parents often complain about the occurrence of edema in children - usually local or general edema, that is, swelling of only one, limited area or uniform swelling of the entire body. Where does this come from? Essentially, edema is excess accumulation tissue fluid in different parts of the body. Edema occurs due to various painful reasons and require attention from the doctor and parents, as they can be one of the first signs of illness internal organs- heart or kidneys. Let's take a closer look at edema and its origin.

First of all, swelling attracts attention if it is very pronounced, or if it is local and large swelling. A small amount of fluid retention in the body may go unnoticed for a long time until the swelling becomes severe enough. Particularly noteworthy are swelling on the face, on the extremities - arms and legs, when it is difficult to move the arms or legs (fingers). In children, edema rarely occurs against the background of complete health, it is episodic, due to external reasons, these are usually signs of quite serious health problems and should not be ignored. In adolescents, edema can occur as a result of hormonal changes in the body and metabolic disorders.

Where does water for swelling come from?
To understand the mechanisms of edema, it is necessary to determine the fluid content in the body and its redistribution throughout the body. First of all, the body of a child and an adult cannot exist without liquid; all types of reactions take place in the aquatic environment. That is why the body is 80-85% water, and without a constant supply of water to the body, a child will not be able to live and be healthy. The situation is worse than with water only with a lack of oxygen. In children, the body is more hydrophilic, that is, saturated with water, the tissues of children are more loose and watery, swelling occurs faster and easier, especially with decreasing age.

All body water is divided into three sectors:
- intracellular water – makes up about a third of the total body weight; it plays virtually no role in the development of edema.
- intravascular fluid is blood and lymph, which circulate through the vessels and are quite mobile - they make up about 8% of body weight. Due to fluctuations in the permeability of vessel walls and the penetration of plasma from vessels into tissues, it plays important role in edema,
- extracellular fluid - makes up about 15% of body weight - this is the fluid that washes the cells from the outside. Collecting between cavities and organs. It is also important in the mechanism of edema formation.

All these water sectors are not separated from each other by blank walls, they actively exchange liquid with each other, water can easily penetrate through semi-permeable membranes, both in one direction and the other. If concentration is violated in one of the sectors certain substances(ions) can lead to the formation of edema. Typically, swelling occurs due to an increase in the amount of fluid between the cells - fluid gets there from the cells or from the vessels, especially when exposed to negative factors.

Types of edema.
Swelling is enough serious symptom, which can clearly demonstrate the presence of any disease in the body or pathological condition. In this case, the manifestation of many edema requires immediate examination and treatment. To identify edema, it is necessary to determine the location of the edema, its characteristics - dense or soft when palpated, what color is the skin above the swelling area, is there a temperature in the area of ​​edema. In this case, it is necessary to apply pressure on the area of ​​swelling with a finger in order to determine the hydrophilicity of the tissue (the degree to which the tissue is saturated with water).

Usually, with swelling, a hole appears, which gradually straightens out. It indicates increased swelling and decreased tissue elasticity. But as the swelling intensifies, the mark from the hole becomes less and less pronounced and the mark from the pressure passes faster. If you gather the skin into a fold, you may feel the doughy texture of the tissue, the fold straightens out slowly, and pits appear in places where finger pressure was applied.

Edema can be general - this is a positive balance of water in the body, which means more fluid enters the body than it is excreted. In this case, swelling can be hidden, which is not visible to the eye and which is noted by a decrease in urine output and an increase in body weight. With such edema, it is important to identify the original place of their formation and whether with such edema there is an accumulation of fluid in the body cavities.

Local edema is an imbalance of fluid in a certain area limited to any part of the body - arm, leg, body, face. Sometimes local edema needs to be distinguished from false edema, when when pressing with a finger on the swelling area, no pits remain.

Causes of edema.
The fluid inside the vessels does not circulate on its own; it is held inside the vessel cavity by special blood plasma proteins - they form a special colloid-oncotic pressure. If the concentration of proteins inside and outside the vessel is disturbed, fluid begins to move from the vessels into the tissues to dilute the concentrations and equalize them. Then the tissues become swollen. Such edema occurs when the amount of proteins in the blood plasma decreases, especially if it is albumin. They have a large mass and bind proteins well. Such protein-associated edematous conditions can occur when:

Protein starvation, when a child has very little protein in his food. Then the expression “to swell from hunger” becomes true. This happens during fasting - both complete and partial - protein.
- if the liver functions in the synthesis of proteins, especially albumin, is impaired. This happens when the liver is damaged by toxic or inflammatory agents.
- if kidney function is impaired and protein is lost in the urine.
- with protein loss through inflamed intestinal walls.

The second important mechanism for the formation of edema is a change in the concentration of sodium ion in the plasma and body fluids. Due to its concentrations it is maintained at the proper level osmotic pressure plasma. Therefore, if there is a lot of sodium in the intercellular space, then water rushes to the zone where there is a lot of sodium and is retained in the intercellular space - edema occurs. This can happen with kidney disease.

Changes in pressure in blood vessels also play a role in the formation of edema, for example, in heart disease. Stagnation occurs in venous vessels, decreases arterial pressure, this leads to the formation of stagnation of blood in the capillaries and the release of the liquid part of the blood from the vessels into the tissues. The pathology of the walls of blood vessels can also have an effect - if they are damaged, their pores are enlarged, then there is increased penetration of fluid into the tissue through such vessels. This happens when inflammation develops.

Also, body fluids are controlled by hormonal systems - especially important are the hormones of the kidneys and adrenal glands. If fluid is rapidly lost around cells or from vessels, the mechanism for producing a special antidiuretic hormone, it reduces the formation and excretion of urine, thus retaining water in the body. Aldosterone also works in parallel with it - it retains sodium in the body and water is retained along with it. If for some reason these hormones begin to be produced in excess, this leads to edema. This happens with some endocrine diseases and kidney damage.

What diseases can cause swelling?
First of all, when edema forms, you need to think about the health of the kidneys and urinary system. Often it is urinary system in children of early and preschool age gives pronounced and slight swelling. Usually these are glomerulonephritis, severe pyelonephritis, congenital anomalies kidney development. In parallel with edema, other symptoms arise - bloody urine, abdominal or lower back pain, problems with urination and the amount of urine.
In this case, swelling occurs on the face - in the area of ​​​​the eyelids and cheeks, and can be from barely noticeable to severe with the inability to open the eyes. Swelling is more pronounced in the morning, after sleep.
Swelling can be caused by some intestinal lesions, in which there is a massive loss of protein from the intestinal walls - celiac disease, ulcerative colitis and enteritis, intestinal polyposis. In such conditions, the body massively loses proteins, especially albumin.

Edema can be observed with cirrhosis of the liver or hepatitis, then swelling occurs in the abdominal area, with accumulation inside abdominal cavity liquids. Edema can occur with heart failure and heart defects; they are characterized by swelling of the extremities and are mainly formed in vertical position and towards evening.

A separate group is formed by edema of an allergic nature; they arise due to damage vascular wall and a sharp increase in its permeability. Swelling can involve the face, neck, eyelids and lips, occurs very quickly and can be hazardous to health.

This is not all we know about edema. So we will continue the conversation next time.

Edema in children - diagnostic methods and assistance:

Occurs under the following conditions:

• right ventricular congestion;
• hypoproteinemia;
• increased capillary permeability, for example acute glomerulonephritis, sepsis, after cardiac surgery.

To identify the causes of swelling diagnostic value has a definition of localization, consistency (soft or dense), color (pale or hyperemic), skin temperature over the area of ​​edema. You can diagnose swelling by pressing on the skin with your finger. The appearance of a pit indicates an increase in skin hydrophilicity and a decrease in its elasticity. The denser the swelling, the smaller the pressure mark. When a skin fold between the fingers is pinched at the site of swelling, a dough-like consistency of the tissue is felt, the fold slowly smoothes out, and a hole remains at the place of compression. Edema should be distinguished from subcutaneous emphysema, in which pressure allows you to feel crepitus.

Generalized (generalized) edema- positive water balance the body as a whole. With slight fluid retention, they speak of hidden edema that does not have clinical manifestations general edema and can be diagnosed by an increasing increase in body weight and a decrease in diuresis. With generalized edema, it is important to find out the initial location of its formation and determine whether there is effusion in the body cavity.

Local (localized) swelling- imbalance of fluid in a limited area of ​​the body or organ.

False edema is an edematous-like change in the skin. Unlike true edema, with false edema, finger pressure does not leave a pit on the skin.

General swelling

Most common reasons common edema in children are diseases of the cardiovascular system and kidneys.

Heart failure is characterized by symmetrical localization of edema on the ankles, and as the disease becomes more severe, on the legs in walking patients; in the tissues of the back, lumbar and sacral regions in bedridden people. Swelling develops slowly, intensifies in the evening, and after sleep decreases or disappears.

In case of kidney diseases, swelling is localized on the face (especially in the eyelid area), and is most pronounced in the morning. With severe swelling of the eyelids, the child's eyes are half-closed, which gives him a drowsy appearance. The skin over the swelling is pale.
General exhaustion in combination with not very pronounced swelling of the legs, feet, puffiness of the face, pollakiuria, polyuria and polydipsia occurs with cachectic edema, which develops during general starvation or with a sharp lack of protein in food, as well as in diseases accompanied by hypoproteinemia: exudative enteropathy, Crohn's disease, ulcerative colitis, celiac disease.

A tendency to retain large amounts of fluid is observed when viral hepatitis. This disease is also characterized by the presence of ascites. If the cause of the development of generalized edema is cirrhosis of the liver, then arterial spider-like hemangiomas can be found in the patient ( spider veins) on the skin, erythema on the palms (hepatic palms), splenomegaly.

It should be remembered that the use of certain medicines, in particular, non-steroidal anti-inflammatory drugs, which are currently widely used in the treatment of fever in children.

Local swelling

With the rapid development of more often unilateral limited edema, more often on the face (ears, lips, eyelids), on the hands and feet, one should think about angioedema. Pulmonary and cerebral edema are also classified as local edema.

False edema on outer surface hips, buttocks occur in premature babies with sclerema. It is very important in the newborn period and in the first months of life to exclude congenital hypothyroidism, in which, due to false mucinous edema of the eyelids, lips, cheeks, a characteristic appearance. Lymphedema of the hands and feet, as well as the presence of “excess” skin on back surface neck in newborns requires excluding Shereshevsky-Turner syndrome.

In newborns, especially premature babies), on the 3-4th day of life, minor swelling may develop on the hands, feet, genitals, which is a consequence of the sexual crisis, features water-salt metabolism, low concentrating ability of the kidneys, transient hypoproteinemia and high permeability of the capillary walls. During a sexual crisis, swelling goes away without treatment within about a week. These edemas should be distinguished from edema with hemolytic disease newborns.

For children infancy, especially with lymphatic-hypoplastic and exudative-catarrhal constitutional anomalies, paratrophy is characterized by hydrolability, which manifests itself in rapid retention and equally rapid loss of fluid, depending on the quality of nutrition and the occurrence of any diseases. In children of this age, the cause of edema is often a deficiency of protein, microelements and vitamins, and pathology of the urinary organs.

Features of examination of children with edema

Anamnesis. When edema appears, it is necessary to clarify whether the child has had an acute respiratory infection, sore throat 10-14 days before the appearance of edema (suspicion of kidney disease), find out the frequency and nature of stool, clarify the nature of nutrition and intake pharmacological drugs, collect allergy history. In children early age it is necessary to assess neuropsychic development and clarify the presence or absence of constipation.

Objective examination. The type of edema is objectively determined (general, local, false), blood pressure is measured, and the state of the cardiovascular system is assessed by auscultation and percussion.

Laboratory examination. General analysis urine, clinical analysis blood, scatological examination. Other laboratory examinations to exclude diseases of the urinary, cardiovascular systems, and gastrointestinal tract diseases are carried out in the hospital.

Consultations with specialists. In the absence of indications for emergency hospitalization the child should be referred for consultation to a nephrologist, cardiologist, endocrinologist, or allergist.

Hospitalization. All patients with generalized edema are subject to hospitalization to determine the cause of their development.

Treatment of edema in a child, what to do

Monitoring the patient

Swelling of the eyelids and face; limited facial expressions due to skin tension.

U infants and patients on bed rest, swelling is located on the back and sides.

With ascites, the abdomen protrudes on the sides.

With pleural effusion - shortness of breath, tachypnea and cyanosis.

Care

Observation of vital functions. Daily weighing, accurate water balance. Intensive body hygiene and skin protection, skin folds should remain dry.

Frequent changes of position (position on the back and side), careful activation. Friendly and calm environment.

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DatsoPic 2.0 2009 by Andrey Datso

No matter where the swelling appears, in any case it indicates the accumulation of excess fluid in the body, and, consequently, general ill-being.

And swelling on the face is no exception. As for children, edema, indicating problems with certain body systems, very often appears on the face, while in adults the same symptom more often appears on the body - all pediatricians are aware of this specificity. So, what could these swellings be, and what do they indicate?

If the swelling appeared after the child hit himself, and it is not severe, this is normal. If there are no others alarms and injuries, and the child behaves normally, you do not need to see a doctor. Immediately after a fall or blow, the child should be calmed down and cold applied to the bruise - this will reduce the swelling and heal faster. But what happens to the baby if swelling on the face appears without any external reasons?

Edema is usually called a phenomenon in which the affected area increases in size and seems to swell, the skin over it becomes stretched, and the surface may become completely hard to the touch. If swelling of the face began unexpectedly and progresses quickly, this is very dangerous symptom, which usually indicates an allergy, and may be accompanied by difficulty breathing and other characteristic phenomena. Immediate help is needed here - you should call an ambulance and give anti-allergy medications.

Children often experience swelling under the eyes. The reason for this phenomenon may even be the fact that the baby periodically touches his eyes with his fingers - he needs to be weaned from touching his face with dirty hands and on the street. The cause of the same phenomenon may be the ingress of foreign object in the eyes - if the day before a child was playing in the sandbox and sand got into his eyes, you should not be surprised that there will be slight swelling under the eyes - you need to rinse the eyes and use eye drops with disinfectant properties. If we are talking about conjunctivitis and other similar diseases eyes - they can also be accompanied by swelling. Sinus infections also give this symptom.

However, if everything is absolutely fine with the baby’s eyes, but there is swelling around the eyes, you need to be vigilant. After all, kidney and heart diseases can have exactly these symptoms in children - it is necessary to be examined by specialists, especially if this swelling is observed day after day and is accompanied by other symptoms characteristic of the heart or kidneys. If a child urinates more often or less often than usual, or if he experiences attacks of weakness, you should rush to see a doctor.

Facial swelling can also be observed with sore throats, especially unilateral ones. This must be reported to your doctor.

If we talk about swelling on the face that accompanies serious illnesses heart and kidneys - as a rule, they are localized not only on this surface. They can also appear on the hips and ankles, at the level of the lower back, and so on. If you notice swelling in your child not only on the face, you should consult a doctor immediately.

Thus, we can summarize the following. If swelling on the face appeared after a minor injury, or if the child simply drank a lot at night, and woke up in the morning with swelling under the eyes, which soon resolved, then everything is fine here, and there is no need to panic. If the swelling develops rapidly, it is most likely an allergic reaction, and the child needs urgent treatment. health care. If a child has a cold or has problems with the eyes, the appearance of edema can also be a completely natural phenomenon. However, if there are kidney or cardiac symptoms, if there is also swelling on the body, it is necessary to examine the baby, because something is wrong with his organs and systems.

And there are also specific childhood diseases that are accompanied by swelling of the face in its normal course- This is, for example, a pig. Here you need to follow the course of treatment prescribed by the doctor, and soon the swelling will go away.

Close in its specificity to injury, and sometimes even to allergies, is an insect bite. If a child is bitten by a bee, do not be surprised that there will be swelling at the bitten area. The child must be calmed, the sting must be removed, and the bite site must be disinfected. If you have multiple bites, you should consult a doctor.

Contact with some poisonous plants can also cause swelling, and here it is important to prevent such phenomena by not letting the baby near such plants, and subsequently explaining that hogweed, for example, can cause severe burns. If the affected area is large, you should consult a doctor if minor manifestations You can limit yourself to providing assistance on your own.

Be attentive to your baby and his general physical condition, contact specialists in a timely manner if necessary - and everything will be fine with your child.