Mesenteric lymphadenopathy in children with recurrent abdominal pain

Authors

  • Saransh Sabal Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India http://orcid.org/0000-0002-6412-9765
  • Lakhan Poswal Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Sandip Gediya Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Suresh Goyal Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20172699

Keywords:

Functional abdominal pain, Mesenteric lymphadenitis, Mesenteric lymphadenopathy, Recurrent abdominal pain

Abstract

Background: Enlarged mesenteric lymph nodes (MLN) are frequently seen in children with abdominal pain and in the absence of other disorders, have been attributed to primary mesenteric lymphadenitis. Mesenteric lymphadenitis is commonly reported in children with acute, chronic or recurrent abdominal pain and no evidence of other pathologies. The purpose of this study was to find out the association of USG finding of enlarged mesenteric lymph nodes with causation of recurrent abdominal pain and outcome of these patients on follow up.

Methods: This hospital based prospective study was done on 82 patients aged 5 to 15 years, attending Bal Chikitsalaya, RNT Medical college, Udaipur, fulfilling Apley’s criteria of RAP. Detailed history, physical examination, relevant investigations and USG abdomen was done in all patients.

Results: Eighty-two children were enrolled; out of which majority (62.19%) were in age group 5-8 years with mean age 7.9±2.69 years. Mesenteric lymphadenopathy was found in 14 (17.07%) cases. All patients with mesenteric lymphadenopathy 14 (100%) had periumbilical pain and diurnal variation of pain. Follow up of 14 patients who had mesenteric lymphadenopathy showed that in 12 (85.71%) patients, the mesenteric lymphadenopathy resolved on USG despite that pain abdomen persisted in 7 (58.33%).

Conclusions: The presence of mesenteric lymphadenopathy can’t be attributed to recurrent abdominal pain.

References

Apley J, Nalsh N. Recurrent abdominal pain: Afield survey of 1000 school children. Arch Dis child. 1958;33:165-70.

Lissauer T, Clayden G. Gastroenterology. Illustrated textbook of Paediatrics. 4th ed. Philadelphia:Elsevier;2012:227.

Bufler Ph, Gross M, Uhlig HH. Recurrent abdominal pain in childhood. Dtsch Arztebl Int. 2011;108(17):205-304.

Macari M, Hines J, Balthazar E, Megibow A. Mesenteric adenitis: CT diagnosis of primary versus secondary causes, incidence, and clinical significance in pediatric and adult patients. AJR 2002;178:853-8.

Karmazyn B, Werner EA, Rejaie B, Applegate KE. Mesenteric lymph nodes in children: what is normal?. Pediatr Radiol. 2005;35:774-7.

Sivit CJ, Newman KD, Chandra RS. Visualization of enlarged mesenteric lymph nodes at US examination. Pediatr Radiol. 1993;23:471-5.

Vayner N, Coret A, Polliack G, Weiss B, Hertz M. Mesenteric lymphadenopathy in children examined by US for chronic and/or recurrent abdominal pain. Pediatr Radiol. 2003;33:864-7.

Watanabe M, Ishii E, Hirowatari Y, Hayashida Y, Koga T, Akazawa K, et al. Evaluation of abdominal lymphadenopathy in children by ultrasonography. Pediatr Radiol 1997;27:860-4

Van der Meer SB, Forget PP, Arends JW, Kuijten RH, Van engelshoven JMA. Diagnostic value of ultrasound in children with recurrent abdominal pain. Pediatr Rediol. 1990;20:501-3.

Chin‐Ling Yip W, Ho TF, Yip YY, Chan KY. Value of abdominal sonography in the assessment of children with abdominal pain. J Clin Ultrasound. 1998; 26:397-400.

Wewer V, Strandberg C, Paerregaard A, Krasilnikoff PA. Abdominal ultrasonography in the diagnostic work-up in children with recurrent abdominal pain. Eur J Pediatr. 1997;156:787-8.

Shanon A, Martin DJ, Feldman W. Ultrasonographic studies in the management of recurrent abdominal pain. Pediatrics. 1990;86:35-8.

Quillin SP, Siegel MJ. Color Doppler US of children with acute lower abdominal pain. Radiographics. 1993;13:1281-93.

Puylaert JB. Mesenteric adenitis and acute terminal ileitis: US evaluation using graded compression. Radiology. 1986;161:691-5.

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Published

2017-06-21

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Original Research Articles