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Mesenteric lymphadenitis
By Mayo Clinic staffMayo Clinic Health Manager
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Definition
Lymph nodes are collections of cells that play a key role in your body's ability to fight off illness. In mesenteric lymphadenitis, the lymph nodes in a membrane that attaches your intestine to your abdominal wall (mesentery) become inflamed — usually as a result of an intestinal infection.
Mesenteric lymphadenitis occurs mainly in children and teens and often mimics the signs and symptoms of appendicitis. Unlike appendicitis, however, mesenteric lymphadenitis is seldom serious and clears on its own in a few days or weeks.
Mesenteric lymphadenitis also can occur in healthy children who have no symptoms. In these cases, swollen lymph nodes are found on imaging tests for another problem. Mesenteric lymphadenitis that doesn't cause symptoms isn't a concern and rarely needs further evaluation.
Symptoms
Signs and symptoms of mesenteric lymphadenitis may last a few days or as long as a few weeks. They include:
- Abdominal pain, often centered on the lower, right side, but the pain can sometimes be more widespread
- Fever
Depending on what's causing the ailment, other signs and symptoms may include:
- Diarrhea
- Nausea and vomiting
- Generally feeling unwell (malaise)
When to see a doctor
Abdominal pain is common in children and teens, and it can be hard to know when it's a problem that needs medical attention. In general, if your child has sudden, severe abdominal pain or pain with fever, bloody diarrhea or vomiting, call your doctor right away. Also call your doctor if mild symptoms don't get better in 5 days or so.
Causes
Your lymph nodes play a vital role in your body's ability to fight off illness. Approximately 600 nodes, scattered throughout your body, trap and destroy viruses, bacteria and other harmful organisms. In the process, the nodes closest to the infection can become sore and swollen — for instance, the lymph nodes in your neck may swell when you have a sore throat. Other nodes that commonly swell are located under your chin and in your armpits and groin.
Although less well known, you also have lymph nodes in the mesentery — the thin tissue that attaches your intestine to your abdominal wall. The most common cause of swollen mesenteric nodes is a viral infection, such as gastroenteritis — commonly known as stomach flu. Mesenteric lymphadenitis can also result from infection with yersinia bacteria, which may come from eating undercooked pork or drinking unpasteurized milk or contaminated water.
Some children develop an upper respiratory infection before or during a bout of mesenteric lymphadenitis, and experts speculate that there may be a link between the two.
Risk factors
Mesenteric lymphadenitis — with or without symptoms — occurs mainly in children and adolescents. The condition may be more common in young boys than it is in girls.
Complications
Mesenteric lymphadenitis usually goes away on its own and rarely causes complications. But if swollen lymph nodes are caused by a serious bacterial infection that isn't treated, the bacteria could conceivably spread to your bloodstream, causing a potentially life-threatening infection (sepsis).
Preparing for your appointment
Young children — and even teens — are often apprehensive about doctor visits, and the anxiety only increases when they're in pain. Here are some ways to help reassure your child before an office visit:
- Explain the reason for the visit. Tell your child that the doctor will try to find what's causing the pain and then look for ways to fix it.
- Describe what to expect during the exam. If you don't know, call the office beforehand to find out what tests your child is likely to have. For instance, if your child is scheduled for an abdominal ultrasound, you can explain that the test doesn't hurt, and that parents can stay in the room during the test. For blood draws, be sure that young children understand that only a small amount of blood will be taken.
- Get your child involved. Write down — or have your child write down — questions for the doctor. Then be sure that they're answered fully and in language your child can understand. Even young children are reassured when they feel that they're participating in their own health care.
Tests and diagnosis
Your doctor is likely to take your child's medical history and ask when and how signs and symptoms developed. In addition, your doctor may request laboratory tests to help pin down the diagnosis, including:
- Blood tests. Certain blood tests can help determine whether your child has an infection and what type of infection it is.
- Imaging studies. A computerized tomography (CT) scan of your child's abdomen can help differentiate between appendicitis and mesenteric lymphadenitis. Abdominal ultrasound also may be used.
Treatments and drugs
Mild, uncomplicated cases of mesenteric lymphadenitis and those caused by a virus usually go away on their own within a few days or weeks. To help ease discomfort, over-the-counter (OTC) pain relievers and fever reducers may help. Your doctor may prescribe antibiotics for a moderate to severe bacterial infection.
Lifestyle and home remedies
For the pain and fever of mesenteric lymphadenitis, have your child:
- Get plenty of rest. Adequate rest can help your child recover.
- Drink fluids. Liquids help prevent dehydration from fever, vomiting and diarrhea.
- Apply moist heat. A warm moist washcloth applied to the abdomen can help ease discomfort.
- Leung AK, et al. Acute abdominal pain in children. American Family Physician. 2003;67(11):2321-2326.
- Vanyer K, et al. Mesenteric lymphadenopathy in children examined by US for chronic and/or recurrent abdominal pain. Pediatric Radiology. 2003;33(12): 864-867.
- Micari M, et al. Mesenteric adentitis: CT diagnosis of primary versus secondary causes, incidence, and clinical significance in pediatric and adult patients. American Journal of Roentgenology. 2002;178:853-858.
- Rathaus V, et al. Enlarged mesenteric lymph nodes in asymptomatic children: The value of the finding in various imaging modalities. The British Journal of Radiology. 2005;78(925):30-33.
- Boaz K. et al. Mesenteric lymph nodes in children: What is normal? Pediatric Radiology. 2005;35(8):774-777.
- Simanovksy N, et al. Importance of sonographic detection of enlarged abdominal lymph nodes in children. Journal of Ultrasound in Medicine. 2007;26(5):581-584.
