What are the symptoms of mesenteric lymph node inflammation?
Mesenteric lymphadenitis is one of the common causes of abdominal pain in children, especially in the spring and autumn seasons, mostly affecting children under 7 years old. Parents may feel extremely anxious and helpless when their children have fever, abdominal pain, sometimes vomiting, and possibly diarrhea. So, how to identify if a child has mesenteric lymphadenitis? What are the specific characteristics of mesenteric lymphadenitis? How to treat it? What precautions should be taken in daily life? This text will explain these questions one by one.
1. After an upper respiratory infection, there may be sore throat, fatigue, followed by fever, abdominal pain, vomiting, sometimes accompanied by diarrhea or constipation. About 22% of children may have enlarged cervical lymph nodes.
2. The earliest symptom is abdominal pain, with an uncertain location, but commonly occurring in the lower right corner. The pain is not fixed, sometimes dull and sometimes spasmodic, with intervals of feeling better. The most sensitive area may vary each time. Pressing the painful area is usually near the midline or slightly higher. Appendicitis, however, has a fixed location. Occasionally, rebound tenderness and abdominal muscle tension may occur. In the lower right abdomen, there may sometimes be tender, small, nodular masses, which are enlarged mesenteric lymph nodes. Observe for any complications of intestinal obstruction.
3. Younger children with symptoms similar to appendicitis but with lighter conditions and no abdominal muscle tension should be considered to have acute mesenteric lymphadenitis. Generally, after fasting, intravenous infusion, and antibiotic treatment, abdominal pain can significantly improve without surgical treatment. However, it is sometimes difficult to distinguish from appendicitis, and surgical exploration is recommended if symptoms do not improve after treatment and observation.
4. After prodromal symptoms such as sore throat, fever, and fatigue before onset, there may be pain in the umbilical and lower right abdomen, nausea, vomiting, and sometimes diarrhea or constipation. This course of illness is the opposite of acute appendicitis, which has abdominal pain before fever, and the body temperature rises suddenly in the early stage of onset. During a physical examination, there may be tenderness in the umbilical and lower right abdomen, with a wide range and unfixed tender points. Due to underdeveloped abdominal muscles in children, abdominal muscle tension may not be obvious. Sometimes, small nodular masses can be palpable. White blood cell count may be increased or normal. If caused by streptococcus, abdominal puncture may aspirate thin, straw-colored fluid, and Gram-positive cocci may be found on smears.
5. One to two days before onset, there may be symptoms of systemic discomfort, sore throat, fever, and other upper respiratory infections, followed by abdominal pain. The pain is mostly located in the lower right abdomen and around the umbilicus, often occurring in paroxysms, like twisting. Eating may cause pain again and lead to vomiting. On physical examination, the child may have facial flushing, pale lips, pharyngeal congestion, and abdominal tenderness distributed diagonally from the lower right to the upper left abdomen, but the lower right abdomen is more obvious, without much muscle tension or rebound tenderness. In thin children, enlarged lymph nodes may be palpable. Clinically, it must be distinguished from acute appendicitis. The former generally has abdominal pain after fever, with不明显转移性 abdominal pain, abdominal pain is often not localized, and the white blood cell count does not increase significantly; the latter mostly has转移性 right lower abdominal pain, which is persistent, with more obvious nausea and vomiting, localized tenderness in the right lower abdomen, often accompanied by abdominal muscle tension and rebound tenderness, and a significant increase in white blood cell count. Typical cases are generally not difficult to distinguish. However, differentiation may be difficult in young children who are uncooperative or unable to express their condition.
