Mesenteric Adenitis – Reasons, Signs, and Treatment

Mesenteric adenitis, also known as mesenteric lymphadenitis, is a condition that causes inflammation of the lymph nodes in the mesentery tissue. This tissue connects the intestines to the abdominal wall, which leads to pain and discomfort. This condition primarily affects children and teenagers. While abdominal pain or pain in the stomach is common in children and is mostly associated with digestive issues, sometimes, it could be because of mesenteric adenitis. The symptoms of mesenteric adenitis may sometimes mimic those of appendicitis. Read on to learn about mesenteric adenitis in children.

What Is Mesenteric Adenitis?

Mesenteric adenitis, also known as mesenteric lymphadenitis, is a condition that causes inflammation of the lymph nodes in the mesentery, located within the abdomen. The lymph nodes, which are part of the lymphatic system, are bean-shaped internal organs that contain lymphocytes, also known as white blood cells. As an essential part of the immune system, these lymph nodes play a crucial role in filtering bacteria and various other types of germs from the body.

When this condition occurs, it affects the lymph nodes in tissues, also called the mesentery. These tissues are responsible for connecting the intestines to the internal lining of the abdominal wall (1).

People who have experienced mesenteric adenitis have a decreased risk for developing ulcerative colitis, a type of inflammatory bowel disease. The specific reason for this lower risk is not known (2).

Is Mesenteric Adenitis Different From Appendicitis?

While both conditions may appear similar due to their shared symptoms, it can sometimes be challenging to differentiate between them. However, appendicitis is the inflammation of the appendix, which is located in the lower right side of the abdomen, and mesenteric adenitis is the inflammation of the lymph nodes in the mesentery. Additionally, appendicitis symptoms may appear suddenly, with or without any preceding illness; however, symptoms of mesenteric adenitis, such as fever or cold, may also develop. Appendicitis is a serious condition and may require surgery, but mesenteric adenitis may get better on its own (3).

A 2010 study concluded that accurate differentiation between acute mesenteric lymphadenitis and acute appendicitis in children cannot be ascertained through clinical assessment alone. In cases where the diagnosis is uncertain, ultrasound imaging should be used (4).

What Are the Causes of Mesenteric Adenitis?

Lymph nodes are a part of the lymphatic system, which is present throughout the human body and plays an active role in the immune system. They store white blood cells for fighting infections. When any kind of infection occurs, the lymph nodes in the close vicinity of the infection are affected the most and thus swell, become painful, and cause discomfort in the abdominal region. This condition typically occurs due to viral infections.

Certain bacterial infections like bacterial gastroenteritis, inflammatory bowel disease, lymphoma or even cancer can be a cause of mesenteric lymph nodes inflammation or enlargement (5).

Mesenteric lymphadenitis can also be caused by tuberculosis, infections associated with HIV, and bacteria present in improperly cooked meat (1).

Common pathogens that can cause mesenteric adenitis are:

Signs and Symptoms of Mesenteric Adenitis

Here are some common symptoms of mesenteric adenitis (1):

• Fever
• Pain in the lower right side of the abdomen or other parts of the abdomen
• Vomiting or nausea
• Lethargy or malaise
• Diarrhoea
• Abdominal tenderness
• Weight loss

Who Is Most at Risk?

This condition may occur at any age; however, it is mostly seen in children (6). If your child falls into any of the following categories, then he can be considered at a higher risk of getting this condition:

• If your child has had a bout of respiratory infection or a cold virus.
• If your child consumed pork that may have been contaminated with the bacteria Yersinia enterocolitica.
• If your child had the stomach flu.

Complications of Mesenteric Adenitis

Although mesenteric adenitis is not a serious ailment. However, in some cases, this condition may result in some of the following complications (7):

• It may lead to joint pain, also known as arthralgia.
• It may cause dehydration if the child has been vomiting or has severe diarrhoea.
• It may form a pus pocket or abscess in the abdomen.
• It may lead to sepsis, which occurs due to the infection that results from systemic inflammatory response syndrome.
• It may lead to a rare condition in which the membrane surrounding the abdominal region becomes inflamed, also known as peritonitis.

Diagnosing Mesenteric Adenitis

Sometimes this condition may be difficult to diagnose as the mesenteric adenitis pain may spread to a wider region. Here are some diagnostic techniques that the doctor may use to establish this condition (8):

• Checking the medical history (such as any previous bouts of cold, flu, fever, etc.) and physical examination (which can include checking for tenderness or swelling in the belly) of your child.
• An ultrasound scan can be conducted to check if the intestinal walls have thickened or if there is any visible mesenteric lymph node enlargement.
• Blood tests can be conducted to check the presence and kind of infection. In some cases, a range of pathogens or even bacteria can be responsible for this condition.
• ACT or computed tomography scan is another method that uses a powerful x-ray imaging technique to examine the abdomen.

Treatment for Mesenteric Adenitis

This condition typically requires no treatment and usually improves on its own within a few days after its onset. However, if the condition occurs due to any kind of bacterial infection, the doctor may prescribe antibiotics. Also, sometimes the doctor may prescribe OTC painkillers such as acetaminophen, ibuprofen, etc. However, do not give aspirin to kids for relieving pain, as it may sometimes lead to a rare life-threatening condition known as Reye syndrome.

Home Remedies for Mesenteric Adenitis

Although this condition gets better on its own, there are certain home remedies you can try to treat it. Simple home remedies like applying hot compression, increasing your child’s fluid intake, or making sure that your child gets ample rest can help. Apart from these, here are some home remedies or natural treatment options that may make your child feel better soon:

1. Using Wild Indigo

This natural medicine is effective in combating various types of infections and supporting the immune system. However, ensure it is administered correctly to minimise the risk of toxicity. This medicine is typically used in combination with echinacea.

2. Using Echinacea

Echinacea is a herb which is obtained from the plant of the same name. This herb has infection-fighting properties, which not only help remove toxins from the body but also boost the immune system.

3. Using Liquorice Root

This root has anti-inflammatory properties and is also helpful in enhancing mucosal properties. Using this root can help in increasing healthy bacteria in the intestinal tract, which in turn can help in treating this condition.

How You Can Prevent Mesenteric Adenitis?

It is difficult to prevent mesenteric adenitis. However, some steps can be taken to avoid the chances of viral and bacterial infections, which can lead to this condition. The following are some preventive measures that can help prevent the chances of this infection in children:

• Do not let your child come in direct or close contact with people who are suffering from any kind of bacterial or viral infection.
• Regular hand-washing (for 15 to 20 seconds) should be encouraged to eliminate any harmful bacteria or viruses that the child may have come into contact with. Using alcohol-based hand sanitisers is also helpful.
• It is essential to regularly disinfect areas such as bathrooms and kitchens, as they can become contaminated and serve as breeding grounds for bacteria and viruses.
• Ensure that your child only drinks filtered water.
• Do not feed any unpasteurized milk to your child. Boil or heat the milk before giving it to your child.
• Ensure the meat or poultry you plan to serve your child is well-cooked, as bacteria present in uncooked meat, such as chicken, turkey, beef, and seafood, may cause infections.

When Should You Contact a Doctor?

Usually, kids complain of stomachaches, which generally subside on their own or with the help of OTC painkillers and other medications. However, symptoms may sometimes become serious, and medical intervention may be necessary. Here are some signs that can be an indication that you need to see a doctor (8):

• If your child’s symptoms do not subside and the condition becomes worse.
• If your child is vomiting, has fever or diarrhoea, or is losing weight.
• If stomach pain becomes more intense or unbearable.
• If your child is passing very little urine.
• If your child becomes exhausted, pale, or starts sweating without any effort.
• If your child experiences difficulty passing gas or stool.

FAQs

1. How common is mesenteric adenitis?

Mesenteric adenitis is a relatively common cause of abdominal pain in kids aged under 16 years. It is much less common in adults. The exact number of occurrences is unknown, as many cases resolve on their own without medical intervention.

2. How long does the pain last?

The pain doesn’t usually prolong more than a few days. The appetite, don’t he other hand, may be a bit low while the nodes remain swollen. Feeding children plenty of fluids will ensure faster recovery (9).

3. Is mesenteric adenitis a serious condition?

Mesenteric lymphadenitis is not a serious condition in children as it often resolves without complications. With acute abdominal pain, children seldom require emergency interventions.

If your child shows any of the above-mentioned signs or symptoms, you should get in touch with your doctor to rule out any complications. Timely diagnosis can help a doctor suggest a treatment for the same.

References/Resources:

1. Cleveland Clinic – Mesenteric Lymphadenitis

2. PubMed Central – Appendicitis, mesenteric lymphadenitis, and subsequent risk of ulcerative colitis: cohort studies in Sweden and Denmark

3. Cleveland Clinic – Appendicitis in Children

4. PubMed – Clinical differentiation between acute appendicitis and acute mesenteric lymphadenitis in children

5. Keystone Radiology – What is Mesenteric Adenitis?

6. PubMed Central – Acute Nonspecific Mesenteric Lymphadenitis: More Than “No Need for Surgery”

7. ScienceDirect – Is mesenteric adenitis a benign condition? Ischemic colitis secondary to mesenteric adenitis in a 12 year old

8. Mayo Clinic – Mesenteric Lymphadenitis

9. Women’s & Children’s Hospital – Mesenteric adenitis

Also Read:

Knee Pain in Kids 
Appendicitis in Kids
Chest Pain in Children
Swollen Lymph Nodes in Children