What causes swollen abdominal lymph nodes in children?

Because children have low body resistance, it is easy for them to have swollen abdominal lymph nodes. When children have swollen abdominal lymph nodes, many parents, especially new parents, do not know what to do. Even if they go to the hospital for treatment, they are worried to death that their children will suffer serious harm. To this end, let us understand what causes swollen abdominal lymph nodes in children.

Abdominal lymphadenopathy in children is mostly caused by viral infection, which is more common in children under 7 years old in winter and spring. It often occurs 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.

Symptoms: Typical manifestations 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 the disease. It can occur in any part of the body, but because the lesion mainly affects 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. For younger children who present with clinical symptoms similar to appendicitis but with milder symptoms and no abdominal muscle tension, acute mesenteric lymphadenitis should be considered. Generally, abdominal pain can be significantly improved after fasting, intravenous infusion, antibiotics, etc., and no surgical treatment is required. However, it is sometimes difficult to differentiate it from appendicitis. If symptoms do not improve after treatment and observation, surgical exploration is recommended. Acute mesenteric lymphadenitis should be considered in children with clinical fever, abdominal pain, vomiting and upper respiratory tract infection, or after intestinal inflammation without abdominal muscle tension.

Characteristics of the disease: 1. Most of the time it occurs in complications of upper respiratory tract infection or intestinal infection, with clinical manifestations such as fever, abdominal pain, and vomiting. 2. Abdominal pain is most common in the right lower abdomen and is paroxysmal and spasmodic. Rebound pain and abdominal muscle tension are rare. 3. Abdominal tenderness is not fixed and may change with changes in body position. 4. Ultrasound examination showed enlarged mesenteric lymph nodes. 5. The diagnosis of this disease needs to be differentiated from acute abdominal diseases such as acute appendicitis, hyperperistalsis of the intestine, and ascariasis. 6. Children with a good prognosis after anti-inflammatory and antiviral treatment who develop high fever and abdominal pain during upper respiratory tract infection or intestinal infection should be considered to have the possibility of concurrent acute mesenteric lymphadenitis. Early abdominal B-ultrasound examination can clarify the diagnosis, prevent misdiagnosis of the disease, help to correctly deal with the disease, guide treatment, and improve efficacy.

Possibility of lymphadenitis. Early abdominal B-ultrasound examination can clarify the diagnosis, prevent misdiagnosis of the disease, help to correctly deal with the disease, guide treatment, and improve efficacy. [2] [Edit this section] Pathology The cause of the disease is that the lymphatic drainage of the distal ileum is very rich, and there are many lymph nodes in the ileum and large intestine. After an upper respiratory tract infection or intestinal infection, viruses, bacteria and their toxins circulate through the blood to the lymph nodes in this area, causing mesenteric lymphadenitis. Virus-infected patients present with mesenteric lymph node hyperplasia, edema, and congestion, but culture is negative. Mesenteric lymphadenitis caused by Salmonella infection is different from viral lymphadenitis. The lymph nodes invaded by bacteria often show acute inflammatory reactions, bleeding and necrosis in the lymph nodes, and Salmonella can be isolated in the lymph nodes.

Pathogenesis: Children's abdominal lymph nodes are distributed along the mesenteric artery and its arterial arch and are very abundant. The terminal ileum and ileocecal region are particularly affected. The contents of the small intestine often stay at the terminal ileum due to the action of the ileocecal valve, so intestinal bacteria and viral products are easily absorbed there.

Examination: White blood cell count may be normal or slightly increased after onset. Pathological manifestations include lymph node hyperplasia, edema, and congestion, but culture is often negative. Both bowel and urinary routine tests were normal. Ultrasound examination showed thickening of the abdominal mesentery and multiple enlarged mesenteric lymph nodes of varying sizes, mostly located in the right lower abdomen. They were smooth and intact in appearance, with clear boundaries between the cortex and medulla, and were hypoechoic. The echoes inside were uniform, and a small amount of fluid dark area was visible in the abdominal cavity. It can also differentiate acute appendicitis, pelvic inflammatory disease, and ovarian disease

Treatment: If the disease has been diagnosed, conservative treatment can be used. Generally, abdominal pain can be significantly improved and gradually recovered through fasting, intravenous infusion and antibiotics, and no surgical treatment is required. 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. The most common gastrointestinal disease caused by Salmonella infection is gastroenteritis, and there are also reports of acute mesenteric lymphadenitis. Mesenteric lymphadenitis caused by Salmonella infection is different from viral lymphadenitis and is more common in children or adolescents. Lymph nodes invaded by bacteria often show acute inflammatory reactions, bleeding and necrosis in the lymph nodes, and Salmonella can be isolated in the lymph nodes. Conservative treatment should be performed first, and if an abscess is formed or symptoms of peritonitis appear, surgical drainage should be performed.

The prognosis is very good and most people recover without any specific treatment. Death is rare and may only occur when secondary specific bacterial infection occurs (suppuration caused by hemolytic streptococci, ruptured lymph nodes and the resulting abscesses and peritonitis).

The above is an introduction to what causes swollen abdominal lymph nodes in children. It should be noted here that children are more susceptible to illness due to their low resistance, but children also have the best recovery ability. Therefore, when children develop swollen abdominal lymph nodes, they can generally recover completely with professional treatment and diet and other care.