Mesenteric adenitis

Mesenteric adenitis
Abdominal ultrasound showing large mesenteric lymph nodes in a 6-year-old with mesenteric lymphadenitis. The largest lymph node (dashed line) measurement was 9 mm.[1]
SpecialtyGeneral surgery
SymptomsMesenteric lymphadenitis
ComplicationsIntussusception[2]
Usual onsetChildren or young adults[1]
CausesUnclear, secondary to infections or inflammatory bowel disease[3]
Risk factorsAfter a upper respiratory infection or gastroenteritis[3]
Diagnostic methodUltrasound, CT scan[1][2]
Differential diagnosisAppendicitis, ectopic pregnancy, inflammatory bowel disease, intussusception[3]
TreatmentSupportive care[3]
MedicationIntravenous fluids, NSAIDs[3]
PrognosisGood[3]

Mesenteric adenitis is inflammation of the mesenteric lymph nodes in the abdomen.[3] Symptoms may include sudden onset of right lower quadrant abdominal pain, fever, and vomiting.[3] Complications can occasionally include intussusception.[2]

The cause is often unclear; though may occur secondary to infections or inflammatory bowel disease.[3] Infections involved may include Epstein-Barr virus and Yersinia enterocolitica among others.[3][4] Often it occurs after an upper respiratory infection or gastroenteritis.[3] Diagnosis may be supported by ultrasound or CT scan, after ruling out other possible causes.[1][2][4] Other conditions that appear similar include appendicitis.[3]

No specific treatment is required, though intravenous fluids or NSAIDs may help with the symptoms.[3] Recover may require a few weeks.[3] It is relatively common, occurring most commonly in children or young adults.[5][1] One trial found that nearly 20% of cases that appeared to be appendicitis were in fact mesenteric adenitis.[3] The condition was first classified in 1926.[2]

Diagnosis

The CT diagnosis is supported by finding more than three lymph nodes larger than 5 mm together with a normal appendix.[2]

References

  1. 1 2 3 4 5 Helbling, R; Conficconi, E; Wyttenbach, M; Benetti, C; Simonetti, GD; Bianchetti, MG; Hamitaga, F; Lava, SA; Fossali, EF; Milani, GP (2017). "Acute Nonspecific Mesenteric Lymphadenitis: More Than "No Need for Surgery"". BioMed research international. 2017: 9784565. doi:10.1155/2017/9784565. PMID 28261620.
  2. 1 2 3 4 5 6 Yang, WC; Chen, CY; Wu, HP (16 December 2013). "Etiology of non-traumatic acute abdomen in pediatric emergency departments". World journal of clinical cases. 1 (9): 276–84. doi:10.12998/wjcc.v1.i9.276. PMID 24364022.
  3. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Otto, M; Nagalli, S (January 2023). "Mesenteric Adenitis". PMID 32809657. {{cite journal}}: Cite journal requires |journal= (help)
  4. 1 2 Radswiki, The. "Mesenteric adenitis | Radiology Reference Article | Radiopaedia.org". Radiopaedia. Archived from the original on 23 June 2022. Retrieved 6 April 2023.
  5. ↑ Gore, Richard M.; Levine, Marc S. (1 December 2014). Textbook of Gastrointestinal Radiology. Elsevier Health Sciences. p. 969. ISBN 978-0-323-27811-9. Archived from the original on 7 April 2023. Retrieved 6 April 2023.
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