Acute mesadenitis: pediatrician point of view
S.I. Bardenikova1, L.A. Shavlokhova1, M.E. Shuvalov2
1Yevdokimov Moscow State University of Medicine and Dentistry
2Children’s City Clinical Hospital of St. Vladimir, Moscow
Mesenteric lymphadenitis (mesadenitis) — a mesenteric lymph nodes inflammation — is the common cause of acute abdominal pain in children. Diagnostic and treatment tactics for mesadenitis is a relevant interdisciplinary problem, which is at the intersection of the pediatricians’ and pediatric surgeons’ interest.
Aim: to analyze the clinical picture impact of the disease onset on diagnosis verification terms of acute mesadenitis in children.
Patients and Methods: 65 children’s case histories (with mesadenitis) aged 1 year and 6 months up to 17 years and 9 months who were treated in the Department of Abdominal Surgery of the Children’s City Clinical Hospital of St. Vladimir in 2012–2017 underwent a retrospective analysis.
Results: it was revealed that there was a high rate of mesadenitis incidence in children of primary school age (average age was 10.5 years) , which correlated with an increasing infection load.
The more pronounced the disease symptoms, the faster the patient comes onto the radar of specialist. Absence of pathognomonic complaints and symptoms in acute mesadenitis, clinical picture polymorphism, and relative rarity and changes’ nonspecificity in complete blood count, biochemical analysis and clinical urinalysis indicators do not allow an accurate diagnosis without the use of additional research. So,
the following instrumental methods of examination are needed for a complete diagnosis verification of acute mesadenitis: abdominal cavity ultrasound, pelvic and retroperitoneum ultrasound for the differential diagnosis of the abdominal pain causes, and diagnostic laparoscopy
for the final diagnosis verification. Serological studies are necessary to establish the etiology of mesadenitis and the complex treatment tactics for the disease. Diagnostic search algorithm expansion among viral infections that ind uce lymphoid proliferation is also advisable.
Conclusion: acute mesadenitis is the interdisciplinary problem of pediatrics and pediatric surgery that requires skilled and consistent joint efforts aimed at accelerating the provision of specialty care to the child.
Keywords: acute mesadenitis, children, disease onset, differential diagnostics, ultrasound, diagnostic laparoscopy.
For citation: Bardenikova S.I., Shavlokhova L.A., Shuvalov M.E. Acute mesadenitis: pediatrician point of view. RMJ. Medical Review. 2019;5:2–10.
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