What are the treatments for mesenteric lymphadenitis in children?

Mesenteric lymphadenitis is a common disease in children. This disease is more often caused by viral infection, so it will have various adverse effects on the growth and healthy development of children. It is easy to cause symptoms such as fever, abdominal pain, vomiting, or diarrhea. As parents, we must detect these symptoms of the disease in children in time and take them to treatment in time.

1. Overview

Acute mesenteric lymphadenitis is easily confused with acute appendicitis clinically. It is more common in children under 7 years old and is mostly a viral infection. It is common in winter and spring, often occurring during the course of acute upper respiratory tract infection or secondary to intestinal inflammation. Typical symptoms are fever, abdominal pain, vomiting, and sometimes diarrhea or constipation. Acute mesenteric lymphadenitis, also known as acute nonspecific mesenteric lymphadenitis, was first proposed by Brenneman (1921). In general cases, drug treatment is effective. However, in a few cases of mesenteric lymphadenitis, purulent abscesses are formed, which require surgical treatment.

2. Symptoms and Signs

Typical symptoms include sore throat, fatigue and discomfort after an upper respiratory tract infection, followed by fever, abdominal pain, vomiting, and sometimes diarrhea or constipation. About 20% of children have swollen cervical lymph nodes.

Abdominal pain is the earliest symptom of this disease. It can occur in any part of the body, but because the lesion mainly invades a group of lymph nodes in the terminal ileum, it is most common in the right lower abdomen. The nature of the abdominal pain is not fixed and can manifest as dull pain or spasmodic pain. The child feels better between two pains. The most sensitive tenderness site may be different in each physical examination. The tenderness site is close to the midline or higher, not fixed like in acute appendicitis, and is milder than in acute appendicitis, with less rebound pain and abdominal muscle tension. Occasionally, a small nodular mass with tenderness can be palpated in the right lower abdomen, which is an enlarged mesenteric lymph node. Some patients may have intestinal obstruction and should be carefully observed.

3. Medication

If the diagnosis has been confirmed, conservative treatment can be used. Generally, the abdominal pain can be relieved by fasting, intravenous infusion and antibiotics.

Improved and recovered gradually without surgical treatment. However, if symptoms do not improve after the above treatment, or if it is difficult to distinguish from acute appendicitis, surgical exploration is recommended. If an abscess forms or symptoms of peritonitis occur, surgical drainage is performed for those caused by Salmonella. Some children may develop intussusception and should be carefully observed.