What is Mesenteric Adenitis?
Mesenteric adenitis is a condition that causes pain in the lower right side of your abdomen, similar to the pain felt with appendicitis. This happens due to inflammation in lymph nodes in your abdomen, nodes are small structures found all over your body that act like filters for bacteria, viruses, and waste in your bloodstream. Because of the similar pain, mesenteric adenitis can be mistaken for appendicitis. It’s important to get to know the distinctive features of these two conditions to ensure accurate diagnosis and treatment. In this article, we will detail the differences between the two and give a more comprehensive explanation on mesenteric adenitis.
What Causes Mesenteric Adenitis?
Mesenteric adenitis, a condition causing inflammation in the lymph nodes in the abdomen, can be caused by several factors. These can include viral or bacterial infections, inflammatory bowel disease, or a type of cancer called lymphoma. Some common bacteria that can cause this condition are Yersinia pseudotuberculosis and Yersinia enterocolitica.
Other bacteria that can cause mesenteric adenitis include salmonella, E coli, and streptococci. The cause of the condition can be classified as either primary or secondary. Primary mesenteric adenitis happens when the swelling in the lymph nodes is caused by an inflammation process that doctors can’t identify. On the other hand, secondary mesenteric adenitis happens when the swelling is caused by an inflammation process in the abdomen that has a known cause or source.
Risk Factors and Frequency for Mesenteric Adenitis
Mesenteric adenitis is a rare and self-healing condition hence, its prevalence is not well known. There’s a notable instance of it in a research study involving 70 children. Originally, all the children were diagnosed with acute appendicitis, yet 16% of them were later found to suffer from mesenteric adenitis. This was determined through surgery, imaging, or monitoring their condition over time.
Signs and Symptoms of Mesenteric Adenitis
Mesenteric adenitis typically appears in children and young adults. This condition is often more common than acute appendicitis in children under ten who experience a sudden onset of pain in the lower right side of their abdomen. Mesenteric adenitis often happens after a recent stomach or upper respiratory infection. Common signs include fever, vomiting, changes in bowel movements, and stomach pain around the belly button or on the lower right side. During a physical check-up, the pain from touching the abdomen is usually less severe in cases of mesenteric adenitis than in acute appendicitis.
- Most common in children and young adults
- Sudden onset of lower right side abdominal pain
- Often follows a recent stomach or upper respiratory infection
- Fever
- Vomiting
- Changes in bowel movements
- Abdominal pain around the belly button or lower right side
- Compared to appendicitis, typically less severe pain when the abdomen is touched during physical examination
Testing for Mesenteric Adenitis
When doctors suspect a patient to have certain conditions like appendicitis, intussusception, or mesenteric adenitis, they might order several tests. This includes a full blood count, a C-reactive protein (CRP) test, and a urine test. The blood count and CRP test check for signs of inflammation in the body, but normal results don’t necessarily rule out these conditions. The urine test helps to check if a urinary tract infection could be causing the symptoms.
Imaging tests, like an ultrasound, are often useful too. Specifically, an abdominal ultrasound is considered the standard way to diagnose mesenteric adenitis. This condition can cause the lymph nodes in the abdomen to become larger and appear darker on the ultrasound image. However, an inflamed appendix, a characteristic sign of appendicitis, would not be present in this case. Nowadays, doctors define mesenteric adenitis as having one or more lymph node measuring 8 mm or more in diameter.
But it can be challenging to diagnose this condition because the lymph nodes could also be enlarged in cases of acute or perforated appendicitis. Luckily, a newer ultrasound technique called superb microvascular imaging Doppler ultrasound might help. This technique can capture low-velocity blood flow with a clearer image compared to the traditional method. In a study that compared this new technique with regular ultrasound for diagnosing mesenteric lymphadenitis in children, it increased the likelihood of correct diagnosis from 63% to 81.5%, and the overall accuracy from 64.9% to 78.9%, showing its potential benefits.
Treatment Options for Mesenteric Adenitis
Mesenteric adenitis is a condition that doesn’t need specific treatment because it typically gets better over time on its own. The first thing doctors do when managing this condition is to rule out other health problems that might need surgical treatment. Once mesenteric adenitis is confirmed, the patient is given supportive care, which usually involves receiving fluids through an IV and taking medications to manage the pain. These medications are usually nonsteroidal anti-inflammatory drugs, also known as NSAIDs.
When diagnosed with mesenteric adenitis, it can cause worry and anxiety for patients and their families because the cause is often unknown. Doctors should clearly explain the diagnosis and how the recovery process can take several weeks. Regular check-ups should also be scheduled during this time to monitor the patient’s progress and address any concerns they might have.
What else can Mesenteric Adenitis be?
When a doctor is trying to determine the cause of a patient’s symptoms, they may consider a number of different conditions. These might include:
- Appendicitis
- Intussusception (a condition where part of the intestine slides into an adjacent part)
- Ovarian cyst rupture
- Ovarian abscess
- Ectopic pregnancy
- Endometriosis
- Ovarian torsion (twisting of the ovary)
- Testicular torsion (twisting of the testicle)
- Epididymitis (inflammation of the tube at the back of the testicle)
- Pelvic inflammatory disease
- Mesenteric ischemia (poor blood supply to the intestines)
- Chronic abdominal pain
- Inflammatory bowel diseases such as Crohn’s or ulcerative colitis
- Systemic lupus erythematous (an autoimmune disease)
- Malignancy (cancer)
- HIV
- Zoonotic infections (infections spread from animals to humans)
- Infectious mononucleosis (caused by the Epstein-Barr virus)
- Tuberculosis
This list represents a wide range of potential conditions, all of which can have different symptoms and require different treatments. As a result, the doctor must consider all of these possibilities in order to make an informed diagnosis.
What to expect with Mesenteric Adenitis
The pain usually goes away within four weeks without any lasting effects. It’s important that patients and their families understand that this is the usual recovery period. They might need to attend follow-up clinic visits to make sure the symptoms completely disappear.
Possible Complications When Diagnosed with Mesenteric Adenitis
Mesenteric adenitis, a condition that results in swollen lymph nodes in the abdomen, typically clears up on its own and does not cause any complications.
- No associated complications
- Resolves without treatment
