From the Research
Mesenteric adenitis is a self-limiting condition that typically resolves within 1-4 weeks without specific intervention, and treatment should focus on supportive care, including hydration, pain management, and rest. The condition is characterized by inflammation of the lymph nodes in the mesentery, often following a viral or bacterial infection, and typically occurs in children and adolescents 1.
Key Considerations
- The diagnosis of mesenteric adenitis is often made based on clinical presentation and imaging findings, such as ultrasonography, which discloses 3 or more mesenteric lymph nodes with a short-axis diameter of 8 mm or more without any identifiable underlying inflammatory process 1.
- Laboratory tests, such as white blood count and C-reactive protein, are of limited usefulness in distinguishing between patients with and without mesenteric lymphadenitis 1.
- A study published in 2021 found that mesenteric adenitis can present with varied findings, and an accurate clinic-radiological diagnosis is important to avoid misdiagnosis and futile interventions 2.
- Another study published in 2018 found that symptoms of mesenteric adenitis can persist for 3 to 10 weeks in half of the patients, and clinical and laboratory characteristics are similar in children with symptoms persisting for 2 weeks or less and in those with symptoms persisting for 3-10 weeks 3.
Treatment Approach
- Supportive care, including hydration, pain management, and rest, is the primary treatment approach for mesenteric adenitis.
- Pain relief can be managed with acetaminophen or ibuprofen, and a bland diet may help reduce digestive discomfort.
- Medical attention should be sought if symptoms worsen, or if there is persistent fever, severe abdominal pain, bloody stools, or signs of dehydration.
Differential Diagnosis
- Mesenteric adenitis can mimic appendicitis, but typically presents with more diffuse abdominal pain, mild fever, and sometimes diarrhea.
- A study published in 2017 found that mesenteric lymphadenitis and acute appendicitis can be differentiated by multiple clinical and laboratory parameters, including duration of symptoms, white blood cell count, and C-reactive protein levels 4.