Children curl up with abdominal pain, beware of acute mesenteric lymphadenitis

This is the 4383rd article of Da Yi Xiao Hu

"Doctor, please save my child," followed by a burst of crying, four or five parents rushed into the emergency room holding a four or five-year-old child. The child curled up in a ball, crying in pain. "The teacher just called, and we rushed to the school to see that he was sweating and had a fever. Does he have appendicitis? Does he need surgery?" The doctor on duty patiently advised, "Don't worry, let me see the child, and we will further confirm the diagnosis after the examination." Finally, it was finally found out that the child did not need surgery, and it was not appendicitis, but acute mesenteric lymphadenitis in children.

1. What is acute mesenteric lymphadenitis

Acute mesenteric lymphadenitis, also known as acute nonspecific mesenteric lymphadenitis, is a common cause of abdominal pain in children. It is more common in children and adolescents, with fever and acute abdominal pain as its clinical features. Drug treatment is generally effective in most cases. However, a small number of cases of mesenteric lymphadenitis may become purulent and form abscesses, which require surgical treatment.

2. Main Causes

Acute mesenteric lymphadenitis in children is generally believed to be caused by respiratory or intestinal viral or bacterial infections. Bacterial and viral infections are more common and are often induced by improper diet or cold.

3. Clinical manifestations

1. Sore throat: mainly manifested as pain in the throat.

2. Fever: The main manifestation is a body temperature exceeding 37.3 degrees Celsius.

3. Abdominal pain: mainly manifested as persistent or paroxysmal abdominal pain.

4. Other symptoms: Some children with acute mesenteric lymphadenitis may experience symptoms such as vomiting, diarrhea or constipation.

4. Who are most likely to get sick?

1. More common in children under 7 years old: due to their young age and low resistance, the mesenteric lymph nodes are easily infected by viruses and bacteria.

2. Boys are more likely to suffer from mesenteric lymphadenitis than girls: The development of boys' mesenteric lymphatic system is slightly behind that of girls, and their estrogen is lower than that of girls. This may be the reason why boys are more likely to suffer from mesenteric lymphadenitis than girls in children.

3. Virus-infected people: People infected with viruses are at risk of developing the disease, such as those infected with respiratory viruses and Mycoplasma pneumoniae.

4. Those who have not received vaccinations in time: Children who have not received relevant vaccines in time are prone to infection with related viruses.

5. About treatment?

1. It should be differentiated from acute appendicitis, periappendiceal abscess, primary peritonitis and mesenteric lymph node tuberculosis.

2. It can be cured through diagnosis and treatment of the primary diseases of upper respiratory tract infection and intestinal infection, as well as symptomatic treatment.

3. The prognosis is good and the treatment cycle is short. Generally, the condition will improve in 3 to 4 days, but it may vary depending on the severity of the disease and personal factors.

4. After timely and standardized treatment, the patient's acute mesenteric lymphadenitis in children can be cured, and the patient's symptoms such as sore throat, fever, abdominal pain, etc. can disappear; if not promptly and standardized treatment is given, the patient may experience vomiting, diarrhea, and water and electrolyte disorders.

6. How to seek medical treatment?

1. Recommended departments: Pediatrics, Gastroenterology

2. If a child has sore throat or fever, please go to the pediatric department for treatment;

3. If vomiting or diarrhea occurs, go to the gastroenterology department for treatment;

4. If the child's symptoms are more acute, such as severe abdominal pain that cannot be relieved, pale complexion, painful expression, etc., he or she can also be sent directly to the emergency department for treatment.

7. Preventive measures?

1. Pay attention to climate changes, prevent colds and fevers, and add or remove clothes in time;

2. Pay attention to food hygiene, avoid eating raw or cold food, and eat regularly.

3. Take a short rest after meal and avoid strenuous exercise.

4. Enhance children's immunity and reduce respiratory and gastrointestinal infections.

The Second Affiliated Hospital of Xi'an Jiaotong University

Supervisor: Pei Honghong, Chief Physician of Emergency Department

Written by: Zhang Ming, head nurse of the emergency department

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All names and place names are pseudonyms and any similarity is purely coincidental.