Mesenteric Adenitis

Question 1

What is mesenteric adenitis?

Answer 1

A common cause of RLQ abdominal pain in children and adolescents, often mimicking appendicitis.

It involves inflammation of the mesenteric lymph nodes in the abdomen.

Question 2

What are the underlying causes of mesenteric adenitis?

Answer 2

The underlying causes include:
* infections
* autoimmune disorders

Specific infections include viral gastroenteritis, Epstein-Barr virus, cytomegalovirus, and adenovirus. Autoimmune disorders may include SLE and IBD.

Question 3

What are the risk factors for mesenteric adenitis?

Answer 3

Risk factors include:
* age (young children, adolescents)
* weakened immunity
* prior GI disease

These factors increase susceptibility to inflammation of the mesenteric lymph nodes.

Question 4

What are the clinical features of mesenteric adenitis?

Answer 4

Clinical features include:
* abdominal pain (RLQ, periumbilical, or diffuse)
* GI symptoms (nausea, vomiting, altered bowel habits, anorexia)
* systemic features (fever, malaise)

Pain on palpation of RLQ may show rebound tenderness.

Question 5

What are the key systemic features associated with mesenteric adenitis?

Answer 5

Key systemic features include:
* fever
* malaise
* history of recent URTI or GI infection.

These features may help in diagnosing mesenteric adenitis.

Question 6

What investigations are used for mesenteric adenitis?

Answer 6

Investigations include:
* abdominal ultrasound
* laparoscopy

These methods help visualize the lymph nodes and assess the condition.

Question 7

What is a major differential diagnosis for mesenteric adenitis?

Answer 7

Appendicitis

Appendicitis presents with peri-umbilical pain that migrates to RLQ, and the pain is continuous and worsens over time.

Question 8

What differentiates gastroenteritis from mesenteric adenitis?

Answer 8

Gastroenteritis affects a wider age range and is associated with recent food intake or contact with infected persons.

Symptoms in gastroenteritis are usually more widespread.

Question 9

What are some non-specific symptoms of lymphoma that could be a differential diagnosis?

Answer 9

Symptoms include:
* fatigue
* weight loss
* night sweats
* persistent lymphadenopathy

These symptoms may complicate the diagnosis of mesenteric adenitis.

Question 10

What is the management strategy for mesenteric adenitis?

Answer 10

Management includes:
* symptom management (analgesia, hydration)
* antibiotic therapy
* hospital admission for IV fluids, uncontrolled pain, or significant systemic symptoms.

Analgesia may include NSAIDs or paracetamol.

Question 11

What are potential complications of mesenteric adenitis?

Answer 11

Complications include:
* peritonitis
* abscess formation
* bowel obstruction
* sepsis
* fistula formation

These complications can arise if mesenteric adenitis is not managed effectively.