Abstract
Purpose: To identify conditions associated with enlarged mesenteric lymph nodes in children with acute abdominal pain and determine the ability of US to detect associated abnormalities.Methods: Two hundred and fifty children with acute abdominal pain were evaluated for the presence of enlarged mesenteric lymph nodes (AP diameter >4 mm). Additionally, a reference group of 50 asymptomatic children was also studied for the presence of enlarged mesenteric lymph nodes.Results: Enlarged mesenteric lymph nodes were noted in 35 (14%) symptomatic children and two (4%) asymptomatic children. A specific diagnosis was established in 16/35 (46%) symptomatic children with mesenteric lymphadenopathy. Acute appendicitis was the most common diagnosis. The discharge diagnosis in the remaining 19 children was abdominal pain or gastroenteritis of unknown origin. US suggested the correct diagnosis in 12/16 (75%) children in whom a definite diagnosis was established. Histopathologic examination of enlarged mesenteric lymph nodes in three patients demonstrated non-specific inflammatory changes.Conclusion: Enlarged mesenteric lymph nodes in children with acute abdominal pain represents a nonspecific finding. Mesenteric lymphadenopathy is associated with a variety of medical and surgical conditions in symptomatic children and is occasionally seen in asymptomatic children. Sonography is useful in establishing a primary diagnosis in these children.
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Puylaert JBCM (1986) Acute appendicitis: US evaluation using graded compression. Radiology 158: 355–360
Jeffrey RB, Laing FC, Townsend RR (1988) Acute appendicitis: sonographic criteria based on 250 cases. Radiology 167: 327–329
Abu-Yousef MM, Bleicher JJ, James JW et al (1987) High resolution sonography of acute appendicitis. AJR 149: 53–58
Vignault F, Filiatraut D, Brandt ML et al (1990) acute appendicitis in children: evaluation with US. Radiology 176: 501–504
Sivit CJ, Newman KD, Boenning DA et al (1992) Appendicitis: usefulness of US in diagnosis in a pediatric population. Radiology 185: 549–552
Gaensler EHL, Jeffrey RB, Laing FC, Townsend RR (1989) Sonography in patients with acute appendicitis: value in establishing alternative diagnoses. AJR 152: 49–51
Siegel MJ, Carel C, Surratt S (1991) Ultrasonography of acute abdominal pain in children. JAMA 266: 1987–1989
Puylaert JBCM (1986) Mesenteric adenitis and acute terminal ileitis: US evaluation using graded compression. Radiology 161: 691–695
Puylaert JBCM, Lalisang RI, van der Werf SDJ, Doombos L (1988) Campylobacter ileocolitis mimicking acute appendicitis: Differentiation with graded-compression US. Radiology 166: 737–740
Dorfman RE, Alpern MB, Gross BH, Sandler MA (1991) Upper abdominal lymph nodes: criteria for normal size determined with CT. Radiology 180: 319–322
Asch MJ, Amoury RA, Touloukian RJ, Santulli TV (1968) Suppurative mesenteric lymphadenitis. Am J Surg 115: 570–573
Jain SK, Khanna SK (1983) Staphylococcal suppurative lymphadenitis. Postgrad Med J 59: 191–193
Kunkel MJ, Brown LG, Banta H, Iannini PB (1991) Meningoccal mesenteric adenitis and peritonitis in a child. Pediatr Infect Dis J 10: 471–473
Olinde AJ, Lucas JF, Miller RC (1984) Acute yersiniosis and its surgical significance. South Med J 77: 1539–1540
Koruda MJ, Bell LM, Ross AJ (1988) Atypical mycobacterial mesenteric lymphadenitis in childhood presenting as an abdominal mass. J Pediatr Surg 23: 526–528
Liebman WM, St Geme JW (1970) Enteroviral pseudoappendicitis. Am J Dis Child 120: 77–78
Pieper R, Kager L, Nasman P (1982) Acute appendicitis: a clinical study of 1,018 cases of emergency appendectomy. Acta Chir Scand 148: 51–62
Lewis FR, Holcroft JW, Boen J, Dunphy JE (1975) Appendicitis: a critical review of diagnosis and treatment in 1000 cases. Arch Surg 110: 677–681
Lau W, Fan S, Yiu T et al (1984) Negative findings at appendectomy. Am J Surg 148: 375–378
Hayden CK, Kuchelmeister J, Lipscomb TS (1992) Sonography of acute appendicitis in childhood: perforation versus nonperforation. J Ultrasound Med 11: 209–216
Quillin SP, Siegel MJ, Coffin CM (1992) Acute appendicitis in children: value of sonography in detecting perforation. AJR 159: 1265–1268
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Sivit, C.J., Newman, K.D. & Chandra, R.S. Visualization of enlarged mesenteric lymph nodes at US examination. Pediatr Radiol 23, 471–475 (1993). https://doi.org/10.1007/BF02012457
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DOI: https://doi.org/10.1007/BF02012457