Mesenteric adenitis in children: sonographic criteria for diagnosis

ABSTRACT

The purpose of this study is to highlight mesenteric adenitis as a frequent cause of acute and recurrent abdominal pain in children and identify the sonographic criteria that can be used in diagnosis and differentiation from other causes of mesenteric lymphadenopathy. 107 children [70 boys, 37 girls] referred to Almadeena medical polyclinic in Mukalla-Yemen with acute or recurrent abdominal pain were evaluated using graded compression sonongraphy for features of mesenteric adenitis. The children were divided into two groups according to their clinical presentation acute and subacute or recurrent, and into three subgroups according to age A1 - less than 5, B 5 - less than 10, C 10-15 y. The number, size, shape, site, echogenicity and color doppler findings of each mesenteric node was recorded and evaluated. The frequency of mesenteric adenitis was higher in boys [n=70 [65.4%]] than girls [n=37 [34.6%]]. Acute presentation resembling appendicitis was higher in older children [age group C], while recurrent presentation is more frequent in younger age [less than 10 years], and in general the disease had a more frequent subacute presentation [67.3%]. The mesenteric lymph nodes detected in each patient were more than 5 in number, mainly in clusters, ovoid or spherical in shape, hypoechoic and sharply demarcated from surroundings, with a hyperechoic center which showed color doppler signal and located mainly in the right lower abdomen but also seen in the left lower abdomen and preaortic area, each one measures >/= 5 mm in short axis, and the long axis of the largest one measures >/= 10 mm. Mesenteric adenitis can be diagnosed when mesenteric lymphadenopathy with sonographic features mentioned above detected by ultrasound in children with acute or recurrent abdominal pain in the absence of sonographic features of appendicitis or other inflammatory abdominal processes