Characteristics of intestinal lymphadenitis in children

Inflammation of intestinal lymph nodes is also common in children's lives. This is also an important cause of abdominal pain in children. It is mainly because bacterial and viral infections cause the body's lymphatic system to work, thus causing lymph node inflammation. The more common feature is that children are prone to fever, vomiting, abdominal pain and other symptoms. After good treatment, the prognosis is very good.

Characteristics of intestinal lymphadenitis in children (1) Most of them occur during complications of upper respiratory tract infection or intestinal infection, with clinical manifestations such as fever, abdominal pain, and vomiting. (2) Abdominal pain is most common in the right lower abdomen and is paroxysmal and spasmodic. Rebound pain and abdominal muscle tension are rare. (3) Abdominal tenderness is not fixed and may change with changes in body position. (4) Ultrasound examination showed enlarged mesenteric lymph nodes. (5) The diagnosis of this disease requires differentiation from acute abdominal diseases such as acute appendicitis, hyperperistalsis, and intestinal ascariasis. (6) The prognosis is good after anti-inflammatory and antiviral treatment. According to our experience, children who develop high fever and abdominal pain during upper respiratory tract infection or intestinal infection should be considered to have the possibility of concurrent acute mesenteric lymphadenitis. Early abdominal B-ultrasound examination can clarify the diagnosis, prevent misdiagnosis of the disease, help to correctly deal with the disease, guide treatment, and improve efficacy.

If the diagnosis has been confirmed, conservative treatment can be used. Generally, abdominal pain can be significantly improved and gradually recovered through fasting, intravenous infusion and antibiotics, and no surgical treatment is required. However, if symptoms do not improve after the above treatment, or if it is difficult to distinguish from acute appendicitis, surgical exploration is recommended. If an abscess forms or symptoms of peritonitis occur, surgical drainage is performed for those caused by Salmonella. Some children may develop intussusception and should be carefully observed.

Examination after onset of the disease may show normal or slightly elevated white blood cell count. Pathological manifestations include lymph node hyperplasia, edema, and congestion, but culture is often negative. Both bowel and urinary routine tests were normal. Ultrasound examination showed thickening of the abdominal mesentery and multiple enlarged mesenteric lymph nodes of varying sizes, mostly located in the right lower abdomen. They were smooth and intact in appearance, with clear boundaries between the cortex and medulla, and were hypoechoic. The echoes inside were uniform, and a small amount of fluid dark area was visible in the abdominal cavity.