Acute Nonspecific Mesenteric Lymphadenitis: More Than "No Need for Surgery"

Abstract

Acute nonspecific, or primary, mesenteric lymphadenitis is a self-limiting inflammatory condition affecting the mesenteric lymph nodes, whose presentation mimics appendicitis or intussusception. It typically occurs in children, adolescents, and young adults. White blood count and C-reactive protein are of limited usefulness in distinguishing between patients with and without mesenteric lymphadenitis. Ultrasonography, the mainstay of diagnosis, discloses 3 or more mesenteric lymph nodes with a short-axis diameter of 8 mm or more without any identifiable underlying inflammatory process. Once the diagnosis is established, supportive care including hydration and pain medication is advised. Furthermore, it is crucial to reassure patients and families by explaining the condition and stating that affected patients recover completely without residuals within 2-4 weeks.

Figure 1

Abdominal ultrasound showing large hypoechoic mesenteric lymph nodes in a 6-year-old girl with acute nonspecific mesenteric lymphadenitis. The largest mesenteric lymph node short-axis diameter (dashed line) measurement was 9 mm.