Mesenteric Adenitis Flashcards
What is the definition of mesenteric adenitis?
Inflammation of lymph nodes in the abdomen
What is the epidemiology of mesenteric adenitis?
Common in children <16 years
What is the pathophysiology of mesenteric adenitis?
Microbial agents from intestinal lymphatics –> move to lymph nodes –> multiply –> inflammation –> supparation
What are some causative organisms of mesenteric adenitis?
Beta-haemolytic strep Staph E. coli Strep. viridans Yersinia Mycobacterium tuberculosis Viruses - adenovirus, rubeola, coxsackie EBV, HIV
What are the symptoms of mesenteric adenitis?
Abdo pain - mainly in RLQ (but can also be diffuse) Fever Diarrhoea Malaise Anorexia Nausea and vomiting
What are the signs of mesenteric adenitis?
RLQ tenderness and guarding
Flushed appearance
Rhinorrhea
Hyperaemic pharynx (red, due to excess of blood)
What investigations should be done for mesenteric adenitis?
Bloods - increased WCC Urine dip - done only if unclear Stool culture - if diarrhoea CT USS
What is the 1st line investigation for mesenteric adenitis?
USS - to exclude other differentials
What imaging modality is best to differentiate between mesenteric adenitis and appendicitis?
CT
Appendicitis will have smaller, fewer, and more localised nodes
What may be seen on CT in mesenteric adenitis?
Enlarged mesenteric lymph nodes
Normal appendix
What is the management for mesenteric adenitis?
Painkillers
Antibiotics - if signs of infection
Diagnostic laparoscopy
When is a diagnostic laparoscopy done in mesenteric adenitis?
If appendicitis cannot be ruled out
