Disease Information for Mesenteric adenitis

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Clinical Manifestations
Signs & Symptoms
Abdominal Mass
Abdominal Pain
Abdominal Pain in Children
Abdominal Pain Nonsurgical
Acute abdomen
Acute abdomen with no signs
Appendicitis pain syndrome
Diffuse Abdominal Pain
Left Lower Quadrant Pain/Tenderness
Lower Abdominal Pain
Periumbilical Pain in Children
Periumbilical Pain in Elderly
Poorly Localized Abdominal Pain
Right Lower Quadrant Pain in Children
Right Lower Quadrant Pain/Tenderness
Severe abdominal pain
Steady abdominal pain
Tender mid-abdominal area/Tenderness
Acutely ill patient/signs
Fever
Fever Febrile Possible
Flu-Like Syndrome
High body temperature
Malaise
Clinical Presentation & Variations
Presentation/Acute abdomen in children
Disease Progression
Course/Acute
Course/Acute only
Laboratory Tests
Abnormal Lab Findings (Non Measured)
Acute inflammatory markers elevated (Lab)
Normal Urinalysis
Diagnostic Test Results
Other Tests & Procedures
Laparoscopy/Abdominal abnormal
X-RAY
Xray/Normal abdomen film
Angiography
Lymphangiogram/Abnormal
Lymphangiogram/Filling defect/lymph nodes
Associated Diseases & Rule outs
Rule Outs
Appendicitis
Crohn's disease (regional enteritis)
Meckel diverticulum
Pancreatitis, acute
Disease Mechanism & Classification
Class
CLASS/Intestinal/stomach/gut (category)
CLASS/Mesentery involvement/disorder (ex)
CLASS/Lymphatics/lymph (category)
Process
PROCESS/Infected organ/abscess (category)
PROCESS/Inflammatory/infection (ex)
Definition

Inflammation of the mesenteric lymph nodes.Background: Mesenteric adenitis is a self-limited inflammatory process that affects the mesenteric lymph nodes in the right lower quadrant. Its clinical presentation mimics that of acute appendicitis. Until recently, the diagnosis was most frequently made when laparotomy performed to assess presumed appendicitis yielded negative findings; now, cross-sectional imaging is routinely applied in the examination of patients.

Pathophysiology: Mesenteric adenitis is most frequently caused by viral pathogens, but other infectious agents have been implicated, including Yersinia enterocolitica, Helicobacter jejuni, Campylobacter jejuni, and Salmonella or Shigella species. An association with streptococcal infections of the upper respiratory tract, particularly the pharynx, has been reported. In younger children and infants, concurrent ileocolitis may be present; this finding suggests that the lymph node involvement may be a reactive process to a primary enteric pathogen.

In the US: In 2 recent series involving patients with clinical symptoms suggestive of acute appendicitis, mesenteric adenitis was the most frequent alternative diagnosis; it was present in 8-12% of patients. In Europe and North America, the proportion of patients with Y enterocolitica infection who undergo appendectomy is 3.0-9.0%.

Internationally: As an etiologic agent of mesenteric adenitis, Y enterocolitica is less common in developing nations than in others. In Europe and North America, the proportion of patients with Y enterocolitica infection who undergo appendectomy is 3.0-9.0%. In 2 small studies of children who underwent appendectomy in Bangladesh, Yersinia organisms were not found. Race: No racial predilection is reported. Sex: Two large published series provide no information about the sex ratio. The clinical differential diagnosis in patients with right lower quadrant pain is broader in girls, especially in adolescents in whom gynecologic pathology must be considered. Age: Mesenteric adenitis can occur in adults, but it is most common in children and adolescents younger than 15 years. Associated enteric disease most often occurs in those younger than 5 years.

Clinical Details: Mesenteric adenitis is a self-limited condition characterized by fever, abdominal pain, nausea, and, occasionally, diarrhea. Pain and tenderness are often centered in the right lower quadrant, but they may be more diffuse than in appendicitis. The site of tenderness may shift when the patient"s position changes, whereas the location of the tenderness tends to be fixed with appendicitis. Leukocytosis is common.

Preferred Examination: Ultrasonography of the right lower quadrant with graded compression has been the mainstay of diagnosis in children. Recently, many centers have adopted CT as an alternate or, sometimes, the primary diagnostic modality in the setting of presumed appendicitis, especially in men and in those in whom visualization of the appendix may be compromised by their body habitus. Although the findings are frequently nonspecific, abdominal radiographs occasionally reveal findings and permit alternative diagnoses (eg, appendicoliths).

With any imaging modality, the finding of lymph node enlargement as an isolated finding is nonspecific; it can be observed several inflammatory processes. Occasionally, nodes exceeding the normal size threshold are observed in children without demonstrable disease. ---[EMedicine website 2007]--------

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External Links Related to Mesenteric adenitis
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PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)
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