TUBERCULOSIS OF THE MESENTERIC L YMPH NODES

TUBERCULOSIS OF THE MESENTERIC L YMPH NODES

Tuberculous mesenteric lymphadenitis is considerably less common than acute non-specific lymphadenitis. Tubercle bacilli, usually , but not necessarily , bovine, are ingested and enter the mesenteric lymph nodes by way of Peyer’s patches. Sometimes only one lymph node is infected; usually there are several, and occasionally massive involvement occurs. The presentation may be with abdominal pain (a rare di ff erential for appendicitis) or with general constitutional symptoms (pyrexia, weight loss, etc.). Calcified lymph nodes may be demonstrated on a plain radiograph of the abdomen, where they must be distinguished from other calcified lesions, e.g. renal or ureteric stones. Johann Conrad Peyer , 1653–1712, Professor of Logic, Rhetoric and Medicine, Scha ff hausen, Switzerland, described the lymph follicles in the intestine in 1677. Sir David Drummond , 1852–1932, born Dublin, Ireland, pathologist and physician at the Royal Victoria Infirmary , Newcastle (1878–1920), President of the British Medical Association (1921–1922) and vice chancellor of the University of Durham (1920–1922). - - -

mesocolon adenitis Mesoileum Figure 65.11 Mesenteric adenitis. (Reproduced with permission from

Coffey JC, Lavery I, Sehgal R (eds). Mesenteric principles of gastro intestinal surgery: basic and applied principles . Boca Raton: CRC Press, 2017: 69–84.)