MESENTERIC ADENITIS

MESENTERIC ADENITIS

• This is inflammation of the lymph nodes of the mesentery - ( Figure 65.11 ). It mostly occurs in the ileocaecal region because of the volume of lymphatic tissue. It is often the site of viral - or infective lymphadenopathy ( Yersinia spp., Campylobacter spp., - Mycobacterium tuberculosis ) and may follow an upper respiratory tract infection with either a viral or bacterial pathogen. Mesen - teric adenitis caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is not uncommon. Swelling of ileocaecal lymph nodes results in capsular stretch and somatic pain in the right iliac fossa. The patient is frequently pyretic (often the temperature is mar kedly elevated) and may have enlarged cervical lymph nodes. During childhood, acute, non-specific mesenteric adenitis is a common condition. The typical history is one of short attacks of central abdominal pain lasting from 10 to 30 min - utes, commonly associated with v omiting. The patient seldom looks ill. In more than half of the cases the temperature is present, shifting tenderness is a valuable sign for di ff erentiating the condition from appendicitis. The neck, axillae and groins should be palpated for enlarged lymph nodes.