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Mesenteric lymphadenitis

Overview

Lymphadenitis is a condition in which your lymph nodes become inflamed. When the condition affects the lymph nodes in the membrane that connects your bowel to the abdominal wall (mesentery), it's called mesenteric lymphadenitis (mez-un-TER-ik lim-fad-uh-NIE-tis).

Mesenteric lymphadenitis, which is also called mesenteric adenitis, usually results from an intestinal infection. It mainly affects children and teens. This painful condition can mimic the warning signs of appendicitis. Unlike appendicitis, mesenteric lymphadenitis is seldom serious and usually clears up on its own.

Mesentery

The mesentery is a fold of membrane that attaches the intestine to the abdominal wall and holds it in place. Mesenteric lymphadenitis is an inflammation of the lymph nodes in the mesentery.

Symptoms

Signs and symptoms of mesenteric lymphadenitis may include:

  • Abdominal pain, often centered on the lower, right side, but the pain can sometimes be more widespread
  • General abdominal tenderness
  • Fever

Depending on what's causing the ailment, other signs and symptoms may include:

  • Diarrhea
  • Nausea and vomiting
  • General feeling of being unwell (malaise)

When to see a doctor

Abdominal pain is common in children and teens, and it can be hard to know when it's a problem that needs medical attention.

In general, call your doctor right away if your child has episodes of:

  • Sudden, severe abdominal pain
  • Abdominal pain with fever
  • Abdominal pain with diarrhea or vomiting

In addition, call your doctor if your child has episodes of the following signs and symptoms that don't get better over a short time:

  • Abdominal pain with a change in bowel habits
  • Abdominal pain with loss of appetite (anorexia)
  • Abdominal pain that interferes with sleep

Causes

The most common cause of swollen mesenteric lymphadenitis is a viral infection, such as gastroenteritis — often called stomach flu. This infection causes the lymph nodes in the mesentery — the thin tissue that attaches your intestine to the back of your abdominal wall — to become inflamed.

Your lymph nodes play a vital role in your body's ability to fight off illness. They're scattered throughout your body to trap and destroy viruses, bacteria and other harmful organisms. In the process, the nodes closest to the infection can become sore and swollen — for instance, the lymph nodes in your neck may swell when you have a sore throat. Other nodes that commonly swell are located under your chin and in your armpits and groin.

Some children develop an upper respiratory infection before or during a bout of mesenteric lymphadenitis. Experts think there may be a link between the two.

Complications

If swollen lymph nodes are caused by a serious bacterial infection that isn't treated, the bacteria could spread to your bloodstream, causing a potentially life-threatening infection (sepsis).

Diagnosis

To diagnosis your child's condition, your doctor is likely to:

  • Perform an exam and take your child's medical history. Your doctor will give your child a physical exam and gather details about his or her signs and symptoms. Your doctor likely will ask about any other medical conditions for which your child has been treated.
  • Request laboratory tests. Certain blood tests can help determine whether your child has an infection and what type of infection it is.
  • Order imaging studies. A computerized tomography (CT) scan of your child's abdomen can help differentiate between appendicitis and mesenteric lymphadenitis. Abdominal ultrasound also may be used.

Treatment

Mild, uncomplicated cases of mesenteric lymphadenitis and those caused by a virus usually go away on their own.

Medications used to treat mesenteric lymphadenitis may include:

  • Over-the-counter pain relievers and fever reducers may help relieve discomfort. Use caution when giving aspirin to children or teenagers. Though aspirin is approved for use in children older than age 3, children and teenagers recovering from chickenpox or flu-like symptoms should never take aspirin. This is because aspirin has been linked to Reye's syndrome, a rare but potentially life-threatening condition, in such children.
  • Antibiotics may be prescribed for a moderate to severe bacterial infection.

Preparing for an appointment

If your child has signs and symptoms common to mesenteric lymphadenitis, make an appointment with your family doctor or a pediatrician. Here's some information to help you get ready for your appointment.

What you can do

Make a list of the following:

  • Your child's symptoms, including nonabdominal symptoms. Include details about when you first noticed these symptoms and how they may have changed or worsened over time. If possible, take your child's temperature several times before your appointment and record the results.
  • Your child's key medical information, including any other health conditions and the names of all medications, vitamins and supplements your child is taking. Also bring a record of your child's recent vaccinations. If your child has been seen for similar signs and symptoms in the past, bring those medical records, if possible.
  • Key personal information, including any recent changes or stressors in your child's life.
  • Questions to ask your doctor. Creating a list of questions in advance can help you make the most of your time with your doctor.

For possible mesenteric lymphadenitis, some questions you might want to ask include:

  • What's the likely cause of my child's condition? Are there any other possible causes?
  • What tests does my child need?
  • Is my child at risk of complications from this condition?
  • Does my child need treatment? If this is due to an infection, should my child take antibiotics?
  • What can I do to help make my child more comfortable? What foods should my child avoid?
  • What signs or symptoms should prompt me to call you while my child is recovering?
  • Is my child contagious?
  • When can my child return to school?

What to expect from your doctor

Some questions the doctor may ask include:

  • When did symptoms begin?
  • Where is the pain located?
  • Has the pain moved from one part of your child's abdomen to another part?
  • How severe is the pain? Does your child cry with pain?
  • What makes the pain more severe?
  • What helps relieve the pain?
  • Do your child's symptoms include nausea? Vomiting?
  • What other signs and symptoms does your child have?
  • Has your child had similar problems before? Did you seek medical care for him or her? If so, do you have medical records of that visit?
  • Do any other children in your family or at school or child care have similar but milder symptoms that you know of?
  • Has your child been diagnosed with any other medical conditions?
  • What medications is your child taking?

Lifestyle and home remedies

For the pain and fever of mesenteric lymphadenitis, have your child:

  • Get plenty of rest. Adequate rest can help your child recover.
  • Drink fluids. Liquids help prevent dehydration from fever, vomiting and diarrhea.
  • Apply moist heat. A warm moist washcloth applied to the abdomen can help ease discomfort.

Last updated: August 23rd, 2016

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