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.
2. Бортулев П.И., Нескучаев В.В. Острый неспецифический мезаденит у детей. Медицинский вестник Северного Кавказа. 2009;1(13):83–84 [Bortulev P.I., Neskuchaev V.V. Acute non-specific mesadenitis in children. Medical Journal of the North Caucasus. 2009;1(13):83–84 (in Russ.)].
3. Сахаутдинов Р.М. Диагностика и лечение острого мезентериального лимфаденита: автореф. дис. … канд. мед. наук. Уфа; 2009. [Sakhautdinov R.M. Diagnosis and treatment of acute mesenteric lymphadenitis: thesis. Ufa; 2009 (in Russ.)].
4. Ольхова Е.Б., Шумейко Н.К., Фомичев М.Ю. Мезаденит у детей с острым абдоминальным болевым синдромом. Клинико-эхографические параллели [обзор]. Вестник рентгенологии и радиологии. 2011;3:45–48 [Olkhova E.B., Shumeiko N.K., Fomichev M.Yu. Mesadenitis in children with acute abdominal pain. Clinical and echographic parallels [review]. Herald of radiology and radiology. 2011;3:45–48 (in Russ.)].
5. Поддубный И.В., Дьяконова Е.Ю., Бекин А.С. и др. Мезаденит как причина синдрома острого живота у детей — аспекты этиологии, диагностики и лечения. Детская хирургия. 2016; 20(1):4–7 [Poddubny I.V., Dyakonova E.Yu., Bekin A.S. et al. Mezadenitis as the cause of acute abdominal syndrome in children — aspects of etiology, diagnosis and treatment. Pediatric surgery. 2016;20(1):4–7 (in Russ.)].
6. Романова Е.А., Намазова-Баранова Л.С., Дьяконова Е.Ю. и др. Острая боль в животе у детей: причины и механизмы формирования. Педиатрическая фармакология. 2017;14(1):55–59 [Romanova E.A., Namazova-Baranova L.S., Dyakonova E.Yu. et al. Acute abdominal pain in children: causes and mechanisms of formation. Pediatric Pharmacology. 2017;14(1):55–59 (in Russ.)].
7. Chanchlani R. Clinical profile and management of mesenteric lymphadenitis in children—our experience. International Journal of Orthopaedics, Traumatology and Surgical Sciences. 2015;1(1):1–4.
8. Maheswari K., Wadhwa L. Clinical profile and causes of mesenteric lymphadenitis in children. Int J Contemp Pediatr. 2016;3:550–552.
9. Фаязов Р.Р., Сагитов Р.Б., Сахаутдинов Р.М. и др. Острый мезентериальный лимфаденит в хирургической практике. Медицинский вестник Башкортостана. 2008;4:53–61 [Fayazov R.R., Sagitov R.B., Sakhautdinov R.M. et al. Acute mesenteric lymphadenitis in surgical practice. Medical Bulletin of Bashkortostan. 2008;4:53–61 (in Russ.)].
10. Helbling R., Conficconi E., Wyttenbach M. et al. Acute Nonspecific Mesenteric Lymphadenitis: More Than “No Need for Surgery”. Biomed Res Int. 2017;2017:4. DOI: 10.1155/2017/9784565
11. Toorenvliet B., Vellekoop A., Bakker R. et al. Clinical differentiation between acute appendicitis and acute mesenteric lymphadenitis in children. European Journal of Pediatric Surgery. 2011;21(2):120–123.
12. Петренко В.М. Лимфатическая система: анатомия и развитие. Фундаментальные исследования. 2010;10:30–34 [Petrenko V.М. Lymphatic system: anatomy and development. Basic research. 2010;10:30–34 (in Russ.)].
13. Тимербулатов В.М., Тимербулатов Ш.В., Фаязов Р.Р. и др. Острый мезентериальный лимфаденит в хирургической практике. Анналы хирургии. 2009;1:34–40 [Timerbulatov V.M., Timerbulatov Sh.V., Fayazov R.R. et al. Acute mesenteric lymphadenitis in surgical practice. Annals of surgery. 2009;1:34–40 (in Russ.)].
14. Борисов А.Е., Кубачев К.Г., Котляр В.Л. и др. Острый мезоаденит как осложнение кишечных инфекций. Учебное пособие для врачей. СПб.; 2004. [Borisov A.Ye., Kubachev K.G., Kotlyar V.L., and others. Acute mesoadenitis as a complication of intestinal infections. A manual for doctors. SPb.; 2004 (in Russ.)].
15. Ризаханов Д.М. Диагностика и лечебная тактика при остром мезоадените в клинике кишечных инфекций: автореф. … дис. канд. мед. наук. СПб.; 2003. [Rizakhanov D.M. Diagnostics and Medical Tactics for Acute Mesoadenitis in the Clinic of Intestinal Infections: thesis. SPb.; 2003 (in Russ.)].
16. Lee C.C., Su C.P., Chen S.Y. et al. Mesenteric adenitis caused by Salmonella enterica serovar Enteritidis. J Formos Med. Assoc. 2004;103(6):463–466.
17. Острый аппендицит у детей. Клинические рекомендации. 2016:28 [Acute appendicitis in children. Clinical guidelines. 2016:28 (in Russ.)].
18. Волосовец А.П., Кривопустов С.П. Абдоминальная боль у детей: проблемно-ориентированный подход. Новости медицины и фармации. 2010;13–14:333–334 [Volosovets A.P., Krivopustov S.P. Abdominal pain in children: a problem-oriented approach. Medical and Pharmacy News. 2010;13–14:333–334 (in Russ.)].
19. Давиденко В.Б. Синдром «острого живота» у детей. Медицина неотложных состояний. 2006; 6(7):109–111 [Davidenko V.B. The syndrome of “acute abdomen” in children. Medicine of emergency. 2006;6(7):109–111 (in Russ.)].
20. Sabal S., Poswal L., Gediya S. et al. Mesenteric lymphadenopathy in children with recurrent abdominal pain. Int J Contemp Pediatr. 2017;4(4):1525–1528.
21. Reust C.E., Williams A. Acute Abdominal Pain in Children. Am Fam Physician. 2016;93(10):830–837.
22. Ивашкин В.Т., Маев И.В., Кучерявый Ю.А. и др. Клинические рекомендации Российской гастроэнтерологической ассоциации по ведению пациентов с абдоминальной болью. Российский журнал гастроэнтерологии, гепатологии и колопроктологии. 2016;25(4):71–80 [Ivashkin V.T., Maev I.V., Kucheryavy Yu.A. et al. Clinical recommendations of the Russian Gastroenterological Association for the management of patients with abdominal pain. Russian Journal of Gastroenterology, Hepatology and Coloproctology. 2016;25(4):71–80 (in Russ.)].
23. Ольхова Е.Б., Щитинин В.Е. Абдоминальный болевой синдром у детей (эхографические варианты). SonoAce International. 2004;12:74–93 [Olkhova E.B., Shchitinin V.E. Abdominal pain syndrome in children (sonographic options). SonoAce International. 2004;12:74–93 (in Russ.)].
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