Mesenteric adenitis Flashcards
Define mesenteric adenitis
Inflammation of the mesenteric lymph nodes
What is the aetiology and risk factors of mesenteric adenitis
Acute enlargement of the intra-abdominal lymph nodes as a results of infection in the upper respiratory tract, chest, or abdomen
The acutely enlarged lymph nodes cause pain
RF: Recent viral infection (URTI, LRTI, gastroenteritis), <15yo
What are the symptoms of mesenteric adenitis
Recent viral infection (URTI, LRTI, gastroenteritis) ± lymphadenopathy
Abdominal pain: Central or RIF
Nausea ± diarrhoea
Reduced appetite
Current signs of infection in throat or chest
More likely to have high fever >39 and dysuria
What are the differentials for mesenteric adenitis
Appendicitis
Gastroenteritis
Constipation
UTI
Somatisation
What are the signs of mesenteric adenitis on examination
Obs: may show fever, otherwise normal
Abdo exam: normal, may be tender
What investigations should be done for mesenteric adenitis
Diagnosis of exclusion
Bedside: urine MC&S, stool culture
Bloods: FBC (Raised WCC), CRP/ESR, U&Es, LFTs, blood gas
Other: US abdomen (exclude appendicits), laparotomy (not required unless unsure): large mesenteric nodes
What is the management for mesenteric adenitis
Simple analgesia (symptoms usually resolve in a few days, maximum 2 weeks)
Safety net for increased pain, deterioration, etc.
Antibiotics if bacterial infection suspected
Laparoscopy to rule out other causes e.g. appendicitis – often diagnosed here (with normal appendix)
What is the prognosis for mesenteric adenitis
Excellent - Symptoms improve within a few days, clearing up completely within 2 weeks