Mesenteric adenitis is a mild condition which causes temporary pain in
the abdomen (tummy), usually in children. It clears up without
treatment. Sometimes mesenteric adenitis is difficult to diagnose, and
it may be difficult to distinguish it from other causes of abdominal
pain such as appendicitis.
What is mesenteric adenitis?
Mesenteric
adenitis means inflamed (swollen) lymph glands in the abdomen, which
cause abdominal pain (tummy pain). It is not serious and will get
better without treatment. Mesenteric adenitis is a fairly common cause
of abdominal pain in children under 16 years, but is less common in
adults.
The name comes from ‘mesentery’, which is the part of
the abdomen where the glands are located, and ‘adenitis’ meaning
inflamed lymph glands.
What are lymph glands?
Lymph glands (also
called lymph nodes) occur throughout the body. They are normally pea
sized. They are a major part of the immune system. During an infection,
lymph glands swell and become painful while the immune system 'fights
off' infecting germs. They go back to normal after the infection is
over.
Most people are familiar with lymph glands in the neck
that can swell when you have a sore throat or tonsillitis. In a similar
way, it is the lymph glands in the abdomen, next to the intestines,
that swell during a bout of mesenteric adenitis. (See separate leaflet
called 'Lymph Glands Swollen' for more about lymph glands.)
What causes mesenteric adenitis?
Probably,
an infection (germ) is what triggers the inflammation and swelling in
the lymph glands. Most cases are probably due to a ‘virus’ infection
such as a cold or sore throat. Less often, it may be a ‘bacterial’
infection that is the cause, for example, a bacterial infection in the
intestine (gut). The inflamed glands then cause pain, tenderness and a
high temperature.
What are the symptoms of mesenteric adenitis?
The symptoms are:
- Pain
in the abdomen (tummy). The pain is usually located either in the
centre of the abdomen, or in the lower right-hand side of the abdomen
(known to doctors as the ‘right iliac fossa’).
- Fever (high temperature) and feeling generally unwell.
- Possibly, you may have some nausea and/or diarrhoea.
- You may have had a sore throat or symptoms of a cold, before the abdominal pain started.
How is mesenteric adenitis diagnosed?
Usually,
it is diagnosed from your symptoms and a doctor’s examination. If you
(or your child) have typical symptoms and there are no signs of
anything else causing the pain, then your doctor may think that
mesenteric adenitis is likely. It is difficult to actually prove the
diagnosis, because the glands are deep in the abdomen and cannot be
seen or felt. So the diagnosis involves excluding other problems which
could cause this type of pain, and then making a presumed diagnosis of
mesenteric adenitis.
Sometimes it is difficult to make a
diagnosis or to rule out other problems. For example, mesenteric
adenitis can imitate other causes of abdominal pain, such as
appendicitis or ectopic pregnancy (there are separate leaflets on these
conditions).
If the diagnosis is not clear, your doctor may suggest:
- A period of observation ('wait and see'), with a review after a few hours to see if symptoms have changed.
- A second opinion, for example, a referral to hospital for a surgeon's opinion.
- Tests to look for other conditions (see below).
Are any tests needed?
There are no specific
tests for mesenteric adenitis. However, some tests may help in
diagnosing other conditions which could be causing the pain. For
example, blood tests, a urine test for infection, or scans (ultrasound
or CT scan).
Note: If there is any possibility that you
could be pregnant, a pregnancy test is essential. This is because a
serious condition called 'ectopic pregnancy', which can occur in early
pregnancy, may cause symptoms similar to mesenteric adenitis.
When might an operation be needed?
In some
cases, problems such as appendicitis or ectopic pregnancy cannot be
ruled out even after tests. If so, you may need an operation to look
inside the abdomen and check for any suspected problem. Sometimes this
can be done as a ‘laparoscopy’, where a thin fibre-optic telescope is
used to look inside the abdomen.
If you have an operation or
laparoscopy, then the inflamed glands may actually be seen. However,
the purpose of the operation is not to look at the glands, but to
ensure that other important problems are not missed.
What is the treatment?
No treatment is
necessary, other than simple painkillers such as paracetamol or
ibuprofen (if wanted). If a bacterial infection is suspected, you may
be given antibiotics, but this is to treat the underlying infection
rather than the mesenteric adenitis.
If your symptoms are getting worse, or last longer than two weeks, you should see a doctor urgently for a review.
What is the outlook?
The symptoms usually improve within a few days, and will almost always clear up completely within two weeks.
Disclaimer: This article is for information only and should not
be used for the diagnosis or treatment of medical conditions. EMIS and
PiP have used all reasonable care in compiling the information but make
no warranty as to its accuracy. Consult a doctor or other health care
professional for diagnosis and treatment of medical conditions.
© EMIS and PiP 2008 Reviewed: 27 Aug 2008
