Extravasation is the leakage of a fluid out of its contained space into the surrounding area, especially

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood is com ...

blood cell A blood cell (also called a hematopoietic cell, hemocyte, or hematocyte) is a cell produced through hematopoiesis and found mainly in the blood. Major types of blood cells include red blood cells (erythrocytes), white blood cells (leukocytes), ...

s from vessels. In the case of

inflammation Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...

, it refers to the movement of

white blood cells White blood cells (scientific name leukocytes), also called immune cells or immunocytes, are cells of the immune system that are involved in protecting the body against both infectious disease and foreign entities. White blood cells are genera ...

through the capillary wall, into the surrounding tissues. This is known as

leukocyte extravasation In immunology, leukocyte extravasation (also commonly known as leukocyte adhesion cascade or diapedesis – the passage of cells through the intact vessel wall) is the movement of leukocytes (white blood cells) out of the circulatory system (ext ...

, also called diapedesis. In the case of

cancer Cancer is a group of diseases involving Cell growth#Disorders, abnormal cell growth with the potential to Invasion (cancer), invade or Metastasis, spread to other parts of the body. These contrast with benign tumors, which do not spread. Po ...

metastasis Metastasis is a pathogenic agent's spreading from an initial or primary site to a different or secondary site within the host's body; the term is typically used when referring to metastasis by a cancerous tumor. The newly pathological sites, ...

, it refers to cancer cells exiting the

capillaries A capillary is a small blood vessel, from 5 to 10 micrometres in diameter, and is part of the microcirculation system. Capillaries are microvessels and the smallest blood vessels in the body. They are composed of only the tunica intima (the in ...

and entering other tissues, where secondary

tumors A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...

may form. The term is commonly used in a medical context. More specifically, extravasation can refer to: * Extravasation (intravenous) * Extravasation of infusates * Extravasation of irrigation fluid * Extravasation of urine *

Leukocyte extravasation In immunology, leukocyte extravasation (also commonly known as leukocyte adhesion cascade or diapedesis – the passage of cells through the intact vessel wall) is the movement of leukocytes (white blood cells) out of the circulatory system (ext ...

* Angiopellosis (non-leukocyte cell extravastion)

Irrigation fluid

Extravasation of irrigation fluid is the unintended migration of irrigation fluid (e.g., saline) introduced into a

human body The human body is the entire structure of a Human, human being. It is composed of many different types of Cell (biology), cells that together create Tissue (biology), tissues and subsequently Organ (biology), organs and then Organ system, org ...

. This may occur in several types of

endoscopic An endoscopy is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are insert ...

surgery, such as minimally invasive orthopedic surgery, i.e., arthroscopy,

TURP Transurethral resection of the prostate (commonly known as a TURP, plural TURPs, and rarely as a transurethral prostatic resection, TUPR) is a urology, urological operation. It is used to treat benign prostatic hyperplasia (BPH). As the name ind ...

(trans-urethral resection of the prostate), and TCRE (trans-cervical resection of the endometrium). In arthroscopy, fluid under pressure is used to inflate and distend a

joint A joint or articulation (or articular surface) is the connection made between bones, ossicles, or other hard structures in the body which link an animal's skeletal system into a functional whole.Saladin, Ken. Anatomy & Physiology. 7th ed. McGraw- ...

and make a working surgical space. An arthroscopy is typically performed on shoulder and knee joints; however, hip arthroscopy is becoming more popular. An arthroscopy is done by making surgical portals or puncture wounds into the joint. A surgical instrument called an arthroscope is used to introduce irrigation fluid under pressure to distend the joint. The arthroscope includes a small (typically 4 mm in diameter) optic scope rod to view the joint. Other portals or puncture wounds are made to introduce surgical instruments to perform cutting or repair procedures. If the joint is surrounded by

soft tissue Soft tissue connective tissue, connects and surrounds or supports internal organs and bones, and includes muscle, tendons, ligaments, Adipose tissue, fat, fibrous tissue, Lymphatic vessel, lymph and blood vessels, fasciae, and synovial membranes.� ...

, as in the shoulder and hip, fluid under pressure may leak out of the joint space through the surgical portals and collect in the patient's soft tissue. A typical arthroscopy can result in 1–3 liters of irrigation fluid being absorbed into the patient's interstitial tissue. This buildup of irrigation fluid in the soft tissue may cause

edema Edema (American English), also spelled oedema (British English), and also known as fluid retention, swelling, dropsy and hydropsy, is the build-up of fluid in the body's tissue (biology), tissue. Most commonly, the legs or arms are affected. S ...

. This swelling can interfere with the arthroscopic procedure by collapsing the surgical space, or migrating into the patient's neck and causing airway blockage. In hip arthroscopy, a feared complication is abdominal flooding where the irrigation fluid leaks from the hip joint capsule and drains into the abdominal cavity. Risk factors for fluid extravasation include procedure length (>90–120 min), obesity, and age (>45–50) with accompanying lack of muscle tone. Shoulder arthroscopy is typically limited to about 90–120 minutes before the swelling from fluid extravasation interferes with the procedure, and presents a potential risk to the patient. Typically, fluid extravasation is managed by controlling fluid pressure, or hastening the procedure.

Infusates

Extravasation may also refer to the leakage of infused substances from the vasculature tissue into the

subcutaneous tissue The subcutaneous tissue (), also called the hypodermis, hypoderm (), subcutis, or superficial fascia, is the lowermost layer of the integumentary system in vertebrates. The types of cells found in the layer are fibroblasts, adipose cells, and ma ...

. The leakage of high- osmolarity solutions or

chemotherapy Chemotherapy (often abbreviated chemo, sometimes CTX and CTx) is the type of cancer treatment that uses one or more anti-cancer drugs (list of chemotherapeutic agents, chemotherapeutic agents or alkylating agents) in a standard chemotherapy re ...

agents can result in significant tissue destruction and significant complications.

References

External links

British National Health Service page on complications from extravasation of infusates

Medical terminology

Irrigation fluid

Infusates

See also

References

Further reading

External links