Mesenteric adenitis

Question 1

Define mesenteric adenitis?

Answer 1

Inflammatory condition of the mesenteric lymph nodes in the abdomen -> mimics appendicitis
Generalised abdominal pain in a generally well child.

Question 2

What is the relevant epidemiology of mesenteric adenitis?

Answer 2

Children and adolescents
Typically follows an upper RTI -> link to viral pathogens

Question 3

What is the aetiology of mesenteric adenitis?

Answer 3

Associate with bacterial or viral infections -> trigger an immune response causing inflammation of mesenteric lymph nodes
Viruses - EBV, adenovirus and enterovirus
Bacteria - Yersinia (water), camplyovacter (poultry or milk)
Rate - mycobacterium, salmonella and streptococcus

Question 4

What are the typical signs and symptoms of mesenteric adenitis?

Answer 4

Diffuse abdominal pain (mimic appendicitis)
Low grade fever
Generalised abdo tenderness
Pharyngitis or sore throat
Nausea
Diarrhoea

(tends not to have loss in appetite and has good overall health)

Question 5

What are the key investigations for a mesenteric adenitis?

Answer 5

FBC - normal wccc (unlike appendicitis)
US abdomen - enlarged, clustered and hypervascular LN

Question 6

What is the typical management for mesenteric adenitis?

Answer 6

Norm self resolves
Conservative - analgesia and fluids
Monitoring for decline
Surgery may be indicated is appendicitis can not be ruled out

Question 7

What is the typical prognosis of mesenteric adenitis?

Answer 7

bacterial may lead to sepsis
Typically good prognosis as self resolves