Acute Nonspecific Mesenteric Lymphadenitis: More Than “No Need for Surgery”

Abstract

Acute nonspecific, or primary, mesenteric lymphadenitis is a self-limiting inflammatory condition affecting the mesenteric lymph nodes, whose presentation mimics appendicitis or intussusception. It typically occurs in children, adolescents, and young adults. White blood count and C-reactive protein are of limited usefulness in distinguishing between patients with and without mesenteric lymphadenitis. Ultrasonography, the mainstay of diagnosis, discloses 3 or more mesenteric lymph nodes with a short-axis diameter of 8 mm or more without any identifiable underlying inflammatory process. Once the diagnosis is established, supportive care including hydration and pain medication is advised. Furthermore, it is crucial to reassure patients and families by explaining the condition and stating that affected patients recover completely without residuals within 2–4 weeks.

A study on chronicity and treatment response of functional abdominal pain in 5 to 15 years of children, in relation to size and location of primary mesenteric lymphadenitis in a tertiary care centre

“…Ovarian hormones can modulate both visceral pain perception and the susceptibility to stress [9]. Mesenteric lymphadenitis typically occurs in children, adolescents, and young adults of both sexes, although males might be slightly more frequently affected than females [10,11,12]. In the present study, children under 11 to 15 years of age, boys were significantly higher in number than girls.…”

Reference intervals of mesenteric lymph node size according to lymphocyte counts in asymptomatic children

“…In the absence of other abnormalities, enlarged mesenteric lymph nodes have been attributed to primary mesenteric lymphadenitis [2,5]. With the estimated reference intervals of the size of LMLN established in this study, the short-axis diameter greater than 8-10 mm could be used as the diagnostic criterion for primary mesenteric lymphadenitis based on the presence of a cluster of three or more mesenteric lymph nodes and in the absence of other abnormalities [2,5,7,19]. Furthermore, the diagnosis of mesenteric lymphadenitis relies on imaging, medical history, and clinical features [20][21][22][23].…”

“…Compared with the definition of MLNE as short-axis diameter � 5 mm, the criterion of MLNE defined as short-axis diameter greater than 8-10 mm should reduce the false positive rate and avoid unnecessary treatments. Mesenteric lymph node enlargement can be associated with primary etiology, or can be secondary to various infectious, malignant, or inflammatory disorders [6,8,19]. In the absence of other abnormalities, enlarged mesenteric lymph nodes have been attributed to primary mesenteric lymphadenitis [2,5].…”

<p><em>Salmonella</em> Mesenteric Lymphadenitis Causing Septic Peritonitis in Two Dogs</p>

“…Mesenteric lymphadenitis is theorized to result from diffuse gastrointestinal inflammatory diseases such as pancreatitis, gastroenteritis, or inflammatory bowel disease. 2,5,13,14 The responsible bacterial agents are theorized to either come from the skin or intestinal tract, and once in the gastrointestinal tract, small amounts migrate to the lymph nodes naturally to contribute to innate immunity. 15 In the presence of inflammatory intestinal disease, however, a large amount of bacteria can migrate into the lymph nodes or translocate into the bloodstream, leading to severe mesenteric lymphadenitis and sepsis.…”

“…Mesenteric lymphadenitis is an inflammatory condition of the lymph nodes and has been documented in humans, pigs, and dogs. [1][2][3][4][5][6][7] The cause of mesenteric lymphadenitis in dogs can either have an immune-mediated 7 or infectious source. 5,8 While uncommon, the disease is important to be aware of as early diagnosis and treatment is critical for a favorable outcome.…”