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

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Last updated: April 11, 2025 • View editorial policy

From the Research

Mesenteric adenitis is a self-limiting condition that can be effectively managed with supportive care, including hydration and pain medication, and typically resolves within 2-4 weeks without residuals 1. The condition presents with right lower quadrant abdominal pain that mimics appendicitis, along with fever, nausea, and sometimes vomiting. Key characteristics of mesenteric adenitis include:

  • Inflammation of the lymph nodes in the mesentery
  • Typically occurs in children and adolescents
  • Often follows a viral or bacterial infection
  • Presents with right lower quadrant abdominal pain, fever, nausea, and vomiting
  • Can be difficult to distinguish from more serious conditions like appendicitis Treatment is primarily supportive, focusing on:
  • Pain management with acetaminophen (10-15 mg/kg every 4-6 hours) or ibuprofen (5-10 mg/kg every 6-8 hours)
  • Adequate hydration
  • Rest during the acute phase
  • Antibiotics may be prescribed if bacterial infection is suspected, typically a broad-spectrum option like amoxicillin-clavulanate According to a recent study, point-of-care ultrasound (POCUS) can identify mesenteric adenitis in pediatric patients with nonsurgical abdominal pain, with high interobserver agreement between experienced and novice physician sonologists 2. Another study found that symptoms of mesenteric adenitis can persist for 3 to 10 weeks in half of the patients, highlighting the importance of considering a longer time span for recovery 3. It is essential to note that while mesenteric adenitis is typically a self-limiting condition, patients should seek immediate medical attention if symptoms worsen significantly, as this condition can sometimes be difficult to distinguish from more serious conditions like appendicitis.

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