From the Research
Mesenteric adenitis is a self-limiting condition that typically resolves on its own within 2-4 weeks without specific treatment, and management should focus on symptomatic relief with hydration, pain medication, and reassurance. The condition is commonly seen in children and adolescents, and its presentation often mimics appendicitis or intussusception, with symptoms including right lower quadrant pain, fever, and nausea 1.
Diagnosis and Management
- The diagnosis of mesenteric adenitis is typically made using 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.
- Management of mesenteric adenitis focuses on symptomatic relief, with recommendations for hydration, pain medication such as acetaminophen or ibuprofen, and reassurance that the condition will resolve on its own without residuals within 2-4 weeks 1.
- Adults can take acetaminophen 500-1000mg every 6 hours (maximum 4g daily) or ibuprofen 400-600mg every 6-8 hours with food, while children's dosing should be weight-based according to package instructions.
- Rest, adequate hydration, and application of heat to the abdomen may provide additional comfort.
Clinical Characteristics and Outcomes
- A recent study 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 2.
- Point-of-care ultrasound (POCUS) can identify mesenteric adenitis in pediatric patients with nonsurgical abdominal pain, both by novice and experienced physician-sonologists, with high interobserver agreement 3.
When to Seek Medical Attention
- Medical attention should be sought if symptoms worsen, persist beyond two weeks, or include severe abdominal pain, persistent vomiting, or signs of dehydration, as these may indicate a different diagnosis requiring specific treatment.