Mesenteric lymphadenitis; a common diagnostic mimic to acute appendicitis. With radiology it is no more a diagnosis of exclusion, laparoscopy or surgery
Abstract
Mesenteric lymphadenitis (ML) is an inflammatory response to viral infections, bacterial infections, inflammatory bowel disease, or lymphoma in the ileocecal regions. It is a common diagnostic mimic to acute appendicitis. It is a self-limited inflammatory process that affects mesenteric lymph nodes in the right lower quadrant (RLQ). We present a 15 year-old-girl with low grade fever and RLQ pain. Initial physical examination and laboratory investigations suggested acute appendicitis. However, diagnosis of ML was established by the finding abnormal lymph nodes that are usually: (a) clusters of > 3 tender ones anterior to right psoas muscle or in the small bowel mesentery, (b) > 5 mm in diameter of short axis, and (b) rounded in shape. In addition; the ileal or ileocecal wall is thickened (> 3 mm) over at least 5 cm of the bowel and the appendicular wall is normal and its lumen is patent. In conclusion; this case reports indicates tha with radiology; ML can be differentiated from acute appendicitis and limits the role of invasive laparoscopy or surgery in exclusion of the latter.
Keywords: appendicitis, CT, mesenteric lymphadenitis, radiology, US.
Keywords:
appendicitis, CT, mesenteric lymphadenitis, radiology, USDOI
https://doi.org/10.22270/jddt.v11i2.4590References
- Ian A. “Acute Non-Specific Mesenteric Lymphadenitis”. Br Med J 1945; 2:680-682.
- Vignault F, Filiatrault D, Brandt ML, Garel L, Grignon A, Ouimet A. Acute appendicitis in children: evaluation with US. Radiol. 1990; 176:501-504.
- Helbling, R., Conficconi, E., Wyttenbach, M., Benetti, C., Simonetti, G. D., Bianchetti, M. G., Hamitaga, F., Lava, S. A., Fossali, E. F., & Milani, G. P. (2017). Acute Nonspecific Mesenteric Lymphadenitis: More Than "No Need for Surgery". BioMed res int. 2017, 9784565.
- Lucey BC, Stuhlfaut JW, Soto JA. Mesenteric lymph nodes: detection and significance on MDCT. AJR Am J Roentgenol. 2005; 184:41-44.
- Sahai S. Lymphadenopathy. Pediatr Rev. 2013; 34: 216-227.
- Carr JA. Acute fulminant necrotizing mesenteric lymphadenitis causing bowel ischemia. J Surg Case Rep. 2019; 2019 (11):rjz304. doi: 10.1093/jscr/rjz304.
- Birkhold M, Langenburg S. Is mesenteric adenitis a benign condition? Ischemic colitis secondary to mesenteric adenitis in a 12 year old. J Pediatr Surg Case Rep. 2016; 15:19-21.
- Zinczuk J, Wojskowicz P, Kisluk J, Fil D, Kemona A, Dadan J. Mesenteric lymphadenitis caused by Yersinia enterocolitica. Prz Gastroenterol. 2015; 10:118-21.
Published
Abstract Display: 1394 
PDF Downloads: 1140 PDF Downloads: 379 How to Cite
Issue
Section
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
How to Cite
.