What is the diagnosis and treatment for Mesenteric adenitis (inflammation of the mesenteric lymph nodes)?

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From the Research

Mesenteric adenitis is a self-limiting condition that can be managed with supportive care, including hydration and pain medication, and does not require surgical intervention. The condition typically occurs in children and adolescents, often following a viral infection, and presents with right lower quadrant abdominal pain that mimics appendicitis, along with fever, nausea, and sometimes vomiting 1.

Key Characteristics of Mesenteric Adenitis

  • The condition is characterized by the enlargement of mesenteric lymph nodes, which can be detected by ultrasonography, with 3 or more lymph nodes having a short-axis diameter of 8 mm or more without any identifiable underlying inflammatory process 1.
  • White blood count and C-reactive protein are of limited usefulness in distinguishing between patients with and without mesenteric lymphadenitis 1.
  • Patients with mesenteric lymphadenitis have significantly longer duration of symptoms prior to emergency department presentation, multiple emergency department presentations, and longer duration of stay in the emergency department compared to patients with acute appendicitis 2.

Treatment and Management

  • Treatment is primarily supportive, focusing on pain management with acetaminophen or ibuprofen, rest, adequate hydration, and a bland diet during acute symptoms 1.
  • Most cases resolve spontaneously within 1-4 weeks without specific intervention 1.
  • Medical attention should be sought if pain becomes severe, persists beyond 2-3 days despite medication, or is accompanied by high fever, persistent vomiting, or bloody stools.

Importance of Proper Diagnosis

  • It is crucial to rule out more serious conditions like appendicitis through proper medical evaluation 1, 2.
  • The absence of any difference with regard to lymph node size might suggest that lymph node enlargement is a non-specific finding 2.

Quality of Life and Outcomes

  • Mesenteric adenitis is generally benign and self-limiting, and patients recover completely without residuals within 2-4 weeks 1.
  • Proper management and diagnosis can improve patient outcomes and reduce the risk of complications 1, 2.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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