What is mesenteric lymphadenopathy?

The number of people catching colds increases in winter and spring, and many of these patients, especially young children, suffer from diarrhea and vomiting in addition to the basic symptoms of a cold. Such patients are usually diagnosed with mesenteric lymphadenopathy. This disease has attracted attention from all sides due to its increased incidence in recent years.

Enlarged and inflamed mesenteric lymph nodes in children are mostly caused by viral infections. They are more common in children under 7 years old in winter and spring. They often occur during the course of acute upper respiratory tract infection or secondary to intestinal inflammation. Typical symptoms are fever, abdominal pain, vomiting, and sometimes diarrhea or constipation.

Symptoms of mesenteric lymphadenitis in children

Typical symptoms include sore throat, fatigue and discomfort after an upper respiratory tract infection, followed by fever, abdominal pain, vomiting, and sometimes diarrhea or constipation. About 20% of children have swollen cervical lymph nodes. Abdominal pain is the earliest symptom of the disease. It can occur in any part of the body, but because the lesion mainly affects a group of lymph nodes in the terminal ileum, it is most common in the right lower abdomen. The nature of the abdominal pain is not fixed and can manifest as dull pain or spasmodic pain. The child feels better between two pains. The most sensitive tenderness site may be different in each physical examination. The tenderness site is close to the midline or higher, not fixed like in acute appendicitis, and is milder than in acute appendicitis, with less rebound pain and abdominal muscle tension. Occasionally, a small nodular mass with tenderness can be palpated in the right lower abdomen, which is an enlarged mesenteric lymph node. Some patients may have intestinal obstruction and should be carefully observed. For younger children who present with clinical symptoms similar to appendicitis but with milder symptoms and no abdominal muscle tension, acute mesenteric lymphadenitis should be considered. Generally, abdominal pain can be significantly improved after fasting, intravenous infusion, antibiotics, etc., and no surgical treatment is required. However, it is sometimes difficult to differentiate it from appendicitis. If symptoms do not improve after treatment and observation, surgical exploration is recommended.

Acute mesenteric lymphadenitis should be considered in children with clinical fever, abdominal pain, vomiting and upper respiratory tract infection, or after intestinal inflammation without abdominal muscle tension.

Features of mesenteric lymphadenopathy

1. Most of them occur in complications of upper respiratory tract infection or intestinal infection, with clinical manifestations such as fever, abdominal pain, and vomiting.

2. Abdominal pain is most common in the right lower abdomen and is paroxysmal and spasmodic. Rebound pain and abdominal muscle tension are rare.

3. Abdominal tenderness is not fixed and may change with changes in body position.

4. Ultrasound examination showed enlarged mesenteric lymph nodes.

5. The diagnosis of this disease needs to be differentiated from acute abdominal diseases such as acute appendicitis, hyperperistalsis of the intestine, and ascariasis.

6. Children with a good prognosis after anti-inflammatory and antiviral treatment who develop high fever and abdominal pain during upper respiratory tract infection or intestinal infection should be considered to have the possibility of concurrent acute mesenteric lymphadenitis. Early abdominal B-ultrasound examination can clarify the diagnosis, prevent misdiagnosis of the disease, help to correctly deal with the disease, guide treatment, and improve efficacy.