English

Abstract

Mesenteric Lymph nodes are frequently visualized by sonography in pediatric patients. The purpose of this study was to evaluate the incidence of the appearance of enlarged mesenteric nodes, in pediatric patients who were referred for abdominal pain of various causes. METHODS: Of the 500 patients who were referred for abdominal pain of various causes, the presence of enlarged nodes, their location, size and other sonological findings were recorded. The patients were divided into two groups. One is those with abdominal pain, due to an acute abdominal condition and those without an acute abdominal condition. The study was carried out in a one year period of March 2010, to March 2011. RESULTS: Enlarged lymph nodes > 5 mm were detected in 25 % of the asymptomatic patients and 27.2% of the patients presenting with abdominal pain. On the basis of this study, mesenteric lymphadenitis should be used for the specific inflammation of the nodes in the appropriate clinical setting. Our study also showed that the 90% of the lymph nodes were seen in the right lower quadrant followed by the left lower quadrant and in the peri-aortic region. Another observation that was made was that - the incidence of enlarged lymph nodes increase with age with the peak incidence at around 5 years and decrease thereafter. CONCLUSION: Enlarged lymph nodes are frequently seen in pediatric patients who are referred for abdominal pain. Mesenteric lymph nodes more than 5mm on their long axis in children presenting with abdominal pain represent Mesenteric Lymphadenitis. INTRODUCTION: Abdominal pain is a frequent symptom in pediatric patients presenting to the outpatient department and causality. Sonography of the abdomen was performed routinely to investigate the cause of pain. The detection of enlarged lymph nodes without any other abnormality is termed mesenteric lymphadenitis, meaning inflammatory process of abdominal lymph nodes. Radiologically the term mesenteric lymphadenitis is used to describe lymph nodes > 5 mm. This retrospective study was performed to evaluate the incidence of mesenteric lymphadenitis as a cause of abdominal pain. As per the study by Sivit CJ, Newman KD, Chandra RS mesenteric lymph nodes were detected in 14% of symptomatic children, but enlarged mesenteric lymph nodes in children with acute pain represents a non-specific finding. The purpose of this study was to explore the prevalence and specific location of the enlarged nodes, and their gender distribution, and associated findings like ascites. MATERIALS AND METHODS: Our study group included 500 successive pediatric patients who were referred for abdominal sonography with abdominal pain. Two experienced radiologists performed all the examinations. Scanning was performed using GE Voluson 730 and Siemens SONOLINE G50Ultrasound machines. The transducers used were convex3.75 MHz and Linear 7.5MHz probes. Scanning of the right and left lower abdominal quadrants and para aortic region were performed with the linear probes routinely. Lymph nodes of size >5mm were documented for further study.