Mesenteric adenolymphitis

Mesenteric adenolymphitis is an inflammation of a part of the abdominal wall. It mainly affects children and can be of viral, bacterial or parasitic origin. Treatment is mainly symptomatic except in the case of bacterial origin where antibiotics must be used.

What is mesenteric adenolymphitis?

Mesenteric adenolymphitis, also called mesenteric adenitis, is an inflammation of the lymph nodes located in the mesentery, a fold of the abdominal peritoneum connecting the small intestine to the posterior wall of the abdomen.

Mesenteric adenolymphitis is common, even commonplace, and typical of young adults and children, in whom it is one of the main reasons for presentation of abdominal pain to the emergency services and one of the main reasons for confusion with appendicitis.

To confirm the diagnosis of mesenteric adenolymphitis it is necessary to use blood cultures, urine microscopic examinations or abdominal CT scan.

Mesenteric adenolymphitis is viral in 80% of cases (Epstein-Barr Virus), more rarely bacterial (yersinia, mesenteric tuberculosis) or parasitic (toxoplasmosis, lambliasis). An ENT infection can be the cause of mesenteric adenolymphitis, causing inflammation of the abdominal lymph nodes.

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The symptoms of mesenteric adenolymphitis

Symptoms of mesenteric adenolymphitis are:

  • Pain in the lower abdomen, most often on the right side
  • Nausea, vomiting
  • Diarrhea
  • Loss of appetite
  • Swelling of the lower abdomen
  • Infections of the respiratory tract
  • Fever

Because of its similar symptoms, mesenteric adenolymphitis is often mistaken for appendicitis in children and adolescents. 10-20% of patients who undergo exploratory surgery for suspected acute appendicitis have their diagnosis corrected to mesenteric adenolymphitis. However, unlike appendicitis, mesenteric adenitis is often accompanied by inflammation of other lymphoid organs, such as the tonsils.

Mesenteric adenitis is usually not serious. However, it can sometimes lead to complications such as:

  • Abscesses
  • Dehydration if the patient has severe diarrhea or vomiting
  • Joint pain
  • Peritonitis, the inflammation of the membrane that surrounds the outside of the organs in the abdomen
  • Sepsis

Treatment of mesenteric adenolymphitis

Adenolymphitis is usually viral in origin, and heals spontaneously. The management of mesenteric adenolymphitis is therefore mainly symptomatic. The treatments associated with mesenteric adenolymphitis are :

  • Painkillers
  • Treatments identical to those proposed for gastroenteritis.
  • Treatments to suppress diarrhea and nausea.
  • Hydration: it is important to drink water in small sips. Intravenous rehydration solution is often considered for younger people.
  • Antibiotics are used when the infection is bacterial in nature.
  • Heat can help relieve a painful lower abdomen. This can be done by placing a hot water bottle on the painful area.
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Preventing mesenteric adenolymphitis

To avoid a bacterial infection, it is advisable to be vigilant in terms of cleanliness of the home and personal hygiene. It is advisable to avoid being around people who are sick and infected by a virus. It is also important to wash your hands regularly with soapy water or an alcohol-based solution in order to remove all germs.

Diet must be monitored to reduce inflammatory phenomena in the intestines and probiotic cures can be beneficial.