Introduction
Mesenteric adenitis, sometimes called “körtelmage” in Swedish, is a condition in which the lymph nodes in the mesentery (the tissue that attaches the intestines to the abdominal wall) become inflamed. This condition most commonly affects children and adolescents and often mimics the symptoms of appendicitis, causing abdominal pain and discomfort.
Causes
Mesenteric adenitis is usually caused by a viral or, less commonly, a bacterial infection. The most common triggers include:
- Viral infections, such as those caused by adenovirus or other common respiratory viruses
- Bacterial infections, such as Yersinia enterocolitica
- Occasionally, gastrointestinal infections or other inflammatory conditions
The inflammation is the body’s response to infection, and the lymph nodes swell as they work to fight off the invading germs.
Symptoms
Symptoms of mesenteric adenitis can be similar to those of appendicitis and may include:
- Abdominal pain, often centered in the lower right side
- Fever
- Nausea and sometimes vomiting
- Diarrhea or, less commonly, constipation
- General malaise or feeling unwell
The pain may be less severe and more diffuse than in appendicitis, and children often appear less acutely ill.
Diagnosis
Diagnosis is based on:
- Medical history and physical examination
- Blood tests to look for signs of infection or inflammation
- Abdominal ultrasound to visualize swollen lymph nodes and rule out appendicitis or other causes of abdominal pain
Mesenteric adenitis is a diagnosis of exclusion, meaning other more serious conditions (like appendicitis) must be ruled out first.
Treatment Options
Mesenteric adenitis is usually a mild, self-limiting condition that resolves on its own. Treatment focuses on relieving symptoms:
- Rest
- Adequate fluid intake
- Pain relief with acetaminophen or ibuprofen if needed
Antibiotics are rarely required unless a bacterial infection is confirmed.
Prevention
There is no specific way to prevent mesenteric adenitis, but general measures to reduce the risk of infections—such as good hand hygiene and avoiding contact with sick individuals—can help.
When to Seek Medical Care
Seek medical attention if your child:
- Has severe or persistent abdominal pain
- Develops a high fever
- Is unable to keep fluids down or shows signs of dehydration
- Has symptoms that worsen or do not improve within a few days
Takeaway
Mesenteric adenitis is a common cause of abdominal pain in children and usually resolves without complications. It is important to distinguish it from more serious conditions like appendicitis. Supportive care and monitoring are usually all that is needed for recovery.