Mesenteric Adenitis

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Definition

-  Acute or chronic inflammation of the mesenteric lymph nodes

 

Features

-  Often found in pts underoing appendicectomy

-  More common in children <15yrs

 

DDx Acute Appendicitis

 

Causes

-  EBV, HIV, Adenovirus, Coxsackieviruses..

-  Beta-haemolytic strep, staph, E. Coli, Yersinia, TB..

 

Associated S/S

-  Abdo pain: often RLQ or diffuse +/- rebound & guarding

-  Fever: 38-38.5oC

-  Diarrhoea

-  Malaise, anorexia

-  Viral URTI

-  Nausea & vomiting (usually precedes pain)

-  Cervical lymphadenopathy 20%

 

Ix

-  FBE: leukocytosis 50%

-  +/- CT–Abdo: only when indicated

-  3+ enlarged mesenteric lymph nodes +/- ileal/ileocaecal thickening

 

Mx

-  Abx if bacterial cause suspected

-  Metronidazole +/-

-  Sx if abscess or peritonitis