Mesenteric Lymphadenopathy

11 year male with complaints of pain abdomen. There was no H/O persistent fever/weight loss/loss of appetitie. There is H/O beef/pork intake in family. Blood reports were normal. USG abdomen showed pre and para aortic lymph nodes. Stool sample showed giardia which was treated with appropriate antibiotics. He recovered well but patient continued to have mild pain occasionally. MRI Abdomen was done. Mesenteric lymphnodes were still present. Is anything to worry..? And further workup required?



Mesentric lymphadenopathy subcentric in children is not significant .It should be labelled as Primary mesentric lymphadenopathy which is common in children .As there is no history of persistent fever. Weight loss, loss,appetite- abdominal tuberculosis is unlikely. As pain is the only symptom and pain decreased after treatment for giardia - a prolonged course of antibiotics like cefuroxime 250 and Ornidazole 250 mg B.D for 10 days,along a Pre- probiotic and digestive enzyme. As frequent viral and bacterial intestinal infections and respiratory infections is associated with this condition- in course of time it will settle
Nice info Sir
Mesenteric Lymphadenopathy Mesenteric lymphadenitis often gets better without treatment. Still, you may need medicine to reduce a fever or control pain. Rest, fluids, and warm heat applied to the abdomen may also help relieve symptoms. You may need treatment for the cause of the inflammation.
Subcentric mesentric lymphnodes not vary significant as there is no h/o wt loss or fever Pt is nonvageterian might be contacting infection every now and than It seems inflammatory or reactionary lymphadenopathy treat with broadspectrum antibiotics Give full course sos may be repeated
Thanx dr Pushkar ji Bhomia

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Observation. Nodes are subcentimeter, and so can be observed. If on subsequent USG abdome, they are found larger, FNAC can be done . RULE out Primary complex by doing xray chest
Sub centric lymph nodes are are accidental finding and non pathological in nature. No active treatment required. Another course antibiotic for giardiasis may be repeated.
Non specific mesenteric adenitis, symptomatic treatment with drotin tab for 15 days. However ppd and CBC, urine routine and c/s maybe done.
Subcentimeter mesenteric lymph node is common finding They are benign and do not require investigation
May be Tuberculous Mesenteric Lymphadenopathy ask for CBC ESR Blood SUGAR TB Gold, Serum ADA,
chest x-ray , CBNAAT Diagnostic Laparoscopy for L.N. Biopsy
Chest xray NORMAL
R /0 Abdominal tuberculosis Ad CBNAAT Lymph node biopsy
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