Mesenteric Lymphadenitis In Children: Symptoms And Treatment

Significant symptoms include enlarged lymph nodes and vomiting, and their severity determines the treatment.

Medically reviewed by Dr. Elna Gibson, MBChB, MMed Dr. Elna Gibson Dr. Elna GibsonMBChB, MMed MomJunction on Facebook Specialty: PediatricsExperience: 25 years
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Mesenteric lymphadenitis diagram

Image: ShutterStock

A widespread abdominal pain may indicate mesenteric lymphadenitis in children. It is the inflammation of the mesenteric lymph nodes, which are clusters of three or more lymph nodes in the right lower mesentery. The peritoneum fold (abdominal cavity membrane) that connects the intestines to the back of the abdominal wall is referred to as the mesentery.

While mesenteric lymphadenitis can occur at any age, it is more common in children (1). Therefore, if your child experiences significant abdominal pain, consult your child’s doctor since it could signify a problem that requires medical attention.

Read on to learn the various causes, symptoms, risk factors, and complications of mesenteric lymphadenitis and how it can be diagnosed, treated, and prevented in the pediatric population.

In This Article

Signs And Symptoms Of Mesenteric Lymphadenitis In Children

Mesenteric lymphadenitis is characterized by swollen lymph nodes. It can be chronic or acute inflammation, depending on the microorganism causing it. Some gastrointestinal symptoms of mesenteric lymphadenitis may include (2):

  • Abdominal pain on the lower right side
  • Fever
  • Abdominal tenderness
  • Enlarged mesenteric lymph nodes (not palpable but diagnosed with ultrasound scan)
  • Nausea
  • Vomiting
  • Diarrhea

Widespread lower right quadrant abdominal pain is a common symptom of mesenteric lymphadenitis in most children

. The above-mentioned signs and symptoms can also be seen in other diseases and may also vary in mesenteric lymphadenitis, depending on the cause.

Causes Of Mesenteric Lymphadenitis In Children

Viral infections

are a major cause of mesenteric lymphadenitis in children. Viral gastrointestinal tract infections, such as stomach flu (viral gastroenteritisiInfectious disease leading to inflammation of the digestive tract with symptoms such as abdominal pain, diarrhea, and nausea ), may cause inflammation of the mesenteric lymph nodes.

The following conditions may also cause inflammation or enlargement of mesenteric lymph nodes (3).

  • Bacterial gastroenteritis
  • Inflammatory bowel diseases (IBD)
  • Lymphoma

protip_icon Point to consider
TuberculosisiInfectious bacterial disease of the lungs that spreads via contaminated droplets released by coughing, sneezing, or speaking , infections related to HIV, and bacteria found in undercooked meat are some factors that may cause mesenteric lymphadenitis (8).

Risk Factors And Complications Of Lymphadenitis In Children

Mesenteric lymphadenitis may lead to dehydration

Image: Shutterstock

The risk factors for mesenteric lymphadenitis can be similar to the risk factors for bacterial or viral gastroenteritis, such as the consumption of contaminated food and water. Children with diagnosed IBD or lymphoma may also have a high risk of lymphadenitis.

Complications of mesenteric lymphadenitis may include (4):

  • Dehydration due to electrolyte and water loss from diarrhea and vomiting
  • PeritonitisiAn inflammation of the inner lining of the belly, the peritoneum, due to infection, surgery, or underlying condition
  • Sepsis
  • AbscessiA painful cavity anywhere on the body, filled with infected tissue (pus), often caused by an infection
  • Arthralgia (joint pain)

When To See A Doctor

Abdominal pain is common in children and teens, and it can be hard to know when it requires medical attention

. However, if your child has severe, sudden onset of abdominal pain, seek immediate medical care since this can even be the symptom of appendicitisiThe inflammation or infection of the appendix, causing pain, digestive problems, and nausea . Abdominal pain with fever, diarrhea, or vomiting also requires medical care to avoid complications (5).

Diagnosis Of Mesenteric Lymphadenitis In Children

A CT scan helps diagnose mesenteric lymphadenitis in children

Image: Shutterstock

Pediatricians will perform a physical examination and also ask about your child’s symptoms and medical history. Depending on the history and physical exam findings, they may order blood tests and abdominal imaging tests to confirm the diagnosis of mesenteric lymphadenitis (6).

Blood tests could help confirm the presence and type of infection, and imaging tests such as abdominal ultrasound or a CT scan give a visualization of mesenteric lymph nodes.

Lifestyle And Home Remedies For Lymphadenitis

Mild mesenteric adenitis after stomach flu can be managed at home through the following ways (5).

  • Adequate rest to enhance recovery
Adequate rest is important to recover from lymphadenitis

Image: Shutterstock

  • Drink enough fluids to prevent dehydration
  • Warm moist heat application using washcloth over the abdomen may help ease pain and discomfort

Home remedies

are enough to treat mild conditions since it is a self-resolving disease. However, seeking expert advice is always helpful to confirm the diagnosis and exclude other causes of abdominal pain in children.

Treatment For Mesenteric Lymphadenitis In Children

Treatment for mesenteric lymphadenitis depends on the underlying cause and severity of the disease. Treatment may include (7):

  • Supportive care with adequate hydration.
  • Mild and uncomplicated mesenteric lymphadenitis due to viral gastroenteritis can be self-limiting and completely resolves within a month or more.
  • Mild cases may not require any specific therapies, and symptoms can be treated by over-the-counter pain and fever medications, such as Tylenol (acetaminophen) and Advil or Motrin (ibuprofen). Aspirin should be avoided since it may cause Reye's syndromeiA rare condition of swelling in the liver and brain leading to loss of consciousness, confusion, or seizures .
  • Moderate to severe lymphadenitis caused by a bacterial infection requires antibiotic treatment.
  • Complications such as suppuration, abscess, or peritonitis are managed with abdominal surgery (laparotomy) and antibiotics.

Although mesenteric lymphadenitis can be cured completely in many children without specific management, a few children with severe infection and associated sepsis may require hospitalization and aggressive management. Untreated severe lymphadenitis can be life-threatening in children.

How To Prevent Mesenteric Lymphadenitis In Children?

Adequate hand hygiene helps prevent mesenteric lymphadenitis in children

Image: Shutterstock

Preventing bacterial and viral infections helps reduce the risk of mesenteric lymphadenitis in children. The following precautions may help reduce the risk of infectious pediatric illnesses in children (8).

  • Wash hands with soap and water
  • Avoid close contact with sick people
  • Do not consume contaminated food and water
protip_icon Quick tip
You may prevent mesenteric lymphadenitis by washing hands before and after touching raw food, cooking meat to an internal temperature of 165°F, and using separate knives and chopping boards for meat and vegetables (8).

Frequently Asked Questions

1. Is mesenteric lymphadenitis serious?

Mesenteric lymphadenitis is seldom serious in children since it often resolves without complications. Although the abdominal pain can mimic an acute abdomen, it may not require emergency interventions, such as appendicitis or intussusception (9).

2. Can COVID-19 cause mesenteric lymphadenitis?

Children with COVID-19 gastrointestinal infections are reported to have mesenteric lymphadenopathy. The imaging tests confirmed the involvement of mesenteric lymphadenopathy in children presenting with abdominal pain. However, most developed severe illnesses require intensive care for COVID-19 symptoms before recovering from mesenteric lymphadenopathy (10).

3. How long does it take for mesenteric lymphadenitis to go away?

Most children can completely recover within four weeks or around. Usually, mild and uncomplicated cases of mesenteric lymphadenitis resolve without specific treatments (9).

4. Can lymphadenitis spread?

Yes. The lymph nodes are infected by either a bacteria, a virus, or a fungus. Once into the lymph nodes, this infection can spread into your bloodstream and other body parts. It needs to be treated quickly to prevent it from spreading through your body.

5. What is the normal size of mesenteric lymph nodes in a child?

According to a study, the lymph nodes of children with mesenteric lymphadenitis and the lymph nodes of normal children were examined with superb microvascular imaging. It showed that the least diameter of lymph nodes in cases of mesenteric lymphadenitis was 0.58±0.15 mm, and of normal mesenteric lymph nodes was 0.47±0.08 mm (p(12).

Mesenteric lymphadenitis in children is an inflammatory condition that can cause fever, abdominal pain, and tenderness. It is recommended to evaluate the sudden onset of severe abdominal pain in children than giving pain relievers since it may mask symptoms. It is the inflammation of lymph nodes attached to the intestines on the lower right side of the abdominal wall. Children with lymphomaiCancer of the lymphatic system, the body’s defense system, that can be environmentally or genetically induced , bacterial gastroenteritis, and inflammatory bowel diseases (IBD) are more prone to develop mesenteric lymphadenitis than others. If left unmanaged, it might complicate sepsisiThe body’s most extreme response to an infection characterized by bacteria entering the bloodstream , peritonitis, and abscess formation. Symptomatic management, antibiotic therapy, or surgery is prescribed depending on the severity of the condition.

Infographic: Potential Causes Of Mesenteric Lymphadenitis In Children

If left untreated, mesenteric lymphadenitis can dehydrate the child and cause severe complications, such as sepsis and arthralgia. Therefore, timely diagnosis and treatment is necessary. The infographic below lists various reasons for mesenteric lymphadenitis in children and preventive tips.

causes and prevention of mesenteric lymphadenitis in children(infographic)

Illustration: Momjunction Design Team

Key Pointers

  • Mesenteric lymphadenitis is commonly seen in children and can occur due to a viral infection of the GI tract.
  • Nausea, fever, or pain in the lower right of the abdomen are a few symptoms they may experience.
  • The doctor may conduct a thorough physical examination and some blood tests to assess the condition.
  • Depending on the results, children may be recommended medications or surgical intervention.
  • Staying hydrated and warm compress may help manage the situation at home.
Mesenteric Lymphadenitis In Children_illustration

Image: Stable Diffusion/MomJunction Design Team

References

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.

1. Rossana Helbling, et al.; Acute Nonspecific Mesenteric Lymphadenitis: More Than “No Need for Surgery; The United States National Library of Medicine
2. Mesenteric Lymphadenitis; Cleveland Clinic
3. What is Mesenteric Adenitis?; Keystone Medical Healthcare services
4. Megan Birkhold and Scott Langenburg; Is mesenteric adenitis a benign condition? Ischemic colitis secondary to mesenteric adenitis in a 12 year old; Sciencedirect; Journal of Pediatric Surgery Case Reports
5. Mesenteric lymphadenitis; Mayoclinic
6. Mesenteric adenitis; Women’s & Children’s Hospital
7. Mesenteric Lymphadenitis; OMICS International
8. Mesenteric Lymphadenitis; Cleaveland Clinic.
9. Mesenteric Lymphadenitis; St. Clair Health.
10. Sakura Noda, et al; Severe COVID-19 initially presenting as mesenteric adenopathy; National Library of Medicine
11. Lymphadenitis.
12. Dao-Ming Zu, et al.; (2019); Evaluation of Mesenteric Lymph Nodes in a Pediatric Population with Mesenteric Lymphadenitis Using Superb Microvascular Imaging.

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Dr. Elna Gibson
Dr. Elna GibsonMBChB, MMed, Paeds
Dr. Elna Gibson is a general pediatrician. She did her MBChB and specialization as a pediatrician in South Africa at the University of Pretoria. She obtained MMed Pediatrics (masters) with distinction in 1993.As a young specialist, Dr.

Read full bio of Dr. Elna Gibson
Dr Bisny T. Joseph
Dr Bisny T. JosephMedical Doctor
Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has around 5 years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert.

Read full bio of Dr Bisny T. Joseph
Swati Patwal
Swati PatwalM.Sc. (Food & Nutrition), MBA
Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children.

Read full bio of Swati Patwal
Anindita Ghatak
Anindita GhatakB.Tech
Anindita Ghatak holds a B.Tech degree in Biotechnology from Amity University, Kolkata. During the course of her studies, she has worked on different research projects in the fields of Microbiology and Bioinformatics. Anindita has over three years of experience writing medical articles for journals.

Read full bio of Anindita Ghatak