mesenteric adenitis
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2021 ◽  
Vol 100 (6) ◽  
pp. 178-181
Author(s):  
S.S. Nikitin ◽  
◽  
Yu.G. Pyattoev ◽  
N.B. Guseva ◽  
M.V. Leukhin ◽  
...  

The authors describe clinical observations of children with acute mesenteric adenitis with PCRconfirmed COVID-19 infection. Attention during ultrasound diagnostics is drawn to the condition of the lymph nodes – mesenteric adenitis in COVID-19 infection was manifested by a significant increase in the size of the nodes – more than 15 mm, a large number of nodes in the cut with a tendency to form a conglomerate, a more rounded shape, significantly increased blood flow, a reaction of the peritoneum in the form its thickening and the presence of free fluid in the abdominal cavity. Unusual for a «ordinary» respiratory viral or intestinal infection type of lymph nodes was the only sign that distinguishes the manifestations of mesenteric infection in COVID-19 infection.


2021 ◽  
Vol 20 (4) ◽  
pp. 22-27
Author(s):  
O. V. Molochkova ◽  
O. B. Kovalev ◽  
O. V. Shamsheva ◽  
A. A. Sakharova ◽  
N. V. Sokolova ◽  
...  

The range of differential diagnostic search in the development of hemorrhagic colitis (hemocolitis) is wide enough and includes infectious and non-infectious factors. Purpose: clinical, laboratory and etiological analysis of bacterial diarrhea occurring with hemorrhagic colitis in the infectious diseases department.Materials and methods: a retrospective study of 141 case histories of those hospitalized in the infectious diseases department of the2 Children's City Clinical Hospital No. 9 named after G.N. Speransky of Moscow in 2019—2021 patients with clinical picture of hemocolitis. Hemocolitis was determined on the basis of macroscopic and microscopic signs (in scatology — mucus, leukocytes, erythrocytes) signs. All patients underwent routine laboratory examinations. The etiology was verified using modern methods of laboratory diagnostics (bacteriological analysis of feces, Latex test, ICA, ELISA, PCR, IHR).Results. There were 137 patients with infectious hemocolitis. Inflammatory bowel disease was diagnosed in 3 children, anus fissure — in 1 child. Young children under 3 years of age prevailed (77%). The etiology of infectious hemocolitis was deciphered in 47 patients (34%). Salmonellosis (36%) and shigellosis (36%) prevailed. Campylobacteriosis, clostridiosis-dificile and klebsiellosis accounted for 11%, 9% and 6% of cases, respectively. Yersiniosis was detected in 1 child at the age of 5 months. The severe form was found in 5.8% of cases, in most cases with shigellosis. Symptoms of intoxication and febrile fever were expressed in all patients, vomiting — in 28.5%, abdominal pain — in 94%, mesenteric adenitis on ultrasound — in 15%, diarrhea with a frequency of more than 5 times a day — in 84%, dehydration — in 64%, intercurrent diseases (ARVI, pneumonia) — in 41.3% of cases. Inflammatory changes in infectious hemocolitis were manifested by an increase in C-reactive protein in 71% (23.91 ± 24.17 mg/l), leukocytosis — in 69% (11.58 ± 3.52 х103 / μl), thrombocytosis — in 26%, an increase in the relative number of stab neutrophils in the general blood test in 78% of cases (10.95 ± 0.4%).Conclusions. Differential diagnostic search in the development of hemocolitis should include modern diagnostic methods, if necessary, additional instrumental studies and specialist consultations to exclude inflammatory bowel diseases.


2021 ◽  
Vol 14 (7) ◽  
pp. e242369
Author(s):  
Jessica Demes ◽  
Carl Kay ◽  
Amilcar Morales-Cardona ◽  
Stalin Subramanian

Yersinia enterocolitica is a Gram-negative bacterium that causes foodborne illnesses, typically characterised by acute febrile gastroenteritis and is associated with a variety of manifestations. Isolated febrile illness without gastrointestinal symptoms is rare. We report a case of Y. enterocolitica infection with severe anicteric hepatitis. A 33-year-old Chinese man with no significant medical history presented on multiple occasions to the emergency department with recurrent high-grade fever and chills, but without gastrointestinal symptoms. Hepatic panel showed rising transaminases that peaked at Aspartate Aminotransferase (AST) of 991 U/L and Alanine Aminotransferase (ALT) of 1664 U/L. CT of the abdomen revealed terminal ileitis and mesenteric adenitis. As part of workup, we found positive serology for Y. enterocolitica. Ultimately, he improved with supportive care. This case highlights the importance of thorough workup of terminal ileitis and ‘Crohn’s mimics’ which ultimately revealed a unifying diagnosis; and an important addition to the workup for undifferentiated severe isolated hepatocellular liver injury.


2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Nik Haszroel Hysham Nik Hashim ◽  
Nur Ain Che Azmi

Both mesenteric adenitis and acute appendicitis may present with fever and right lower quadrant pain. This presentation makes it challenging to provide a timely and accurate diagnosis to avoid unnecessary surgery. We report a case of an 8-year-old who was admitted with fever and right lower quadrant pain, loss of appetite, and diarrhoea. There were tenderness and rigidity in the right lower quadrant of the abdomen. Hepatomegaly was present. Full blood count showed pancytopenia, and serum transaminases were mildly elevated. The clinical features in typhoid fever are not specific, making it difficult to differentiate from other infectious causes such as malaria, dengue, or leptospirosis, common in the region. This report illustrates a rare case of mesenteric adenitis caused by Salmonella serotype Typhi. It also shows the benefit of doing an abdominal ultrasound to help the surgeon decide whether surgery is necessary.


2021 ◽  
pp. 195-201
Author(s):  
Eli D. Ehrenpreis
Keyword(s):  

2020 ◽  
Vol 8 (4) ◽  
pp. 200-205
Author(s):  
Manish Pokhrel

Background: Acute appendicitis and acute mesenteric adenitis have very similar clinical presentations but radically different treatment approaches in children. Objectives: This study aims to test the possibility of clinically distinguishing between acute appendicitis and acute mesenteric adenitis. Methodology: A cross-sectional study was designed to recruit all children (<16 years) presenting to Kathmandu Medical College Teaching Hospital with acute abdominal pain between July 2019 and November 2019. An initial diagnosis was made using clinical and laboratory data. Then all patients were subjected to ultrasound evaluation. The final diagnosis was based on the radiological or histopathological examination. The Paediatric Appendicitis score was calculated retrospectively, and a logistic regression model was used to assess the diagnostic accuracy of the clinical parameters. Results: A total of 107 patients were analysed. Among them, 31(28.97%) had acute appendicitis and 34 (31.77%) had acute mesenteric adenitis as the final diagnosis. The positive predictive value of clinical diagnosis was 0.91 for acute appendicitis and 0.73 for acute mesenteric adenitis, for Paediatric Appendicitis Score was 0.77 and for the predictive model to diagnose acute mesenteric adenitis was 0.89. Ultrasound had a positive predictive value of 0.97 to diagnose acute appendicitis and 0.94 to diagnose acute mesenteric adenitis. Conclusion: Although several clinical parameters show promise in differentiating AA from AMA, relying solely on clinical differentiation is not accurate enough to prevent diagnostic errors. It is still recommended to utilise abdominal ultrasound for the assessment of abdominal pain in children.


2020 ◽  
Vol 2020 (9) ◽  
Author(s):  
Rachel Harwood ◽  
Roland Partridge ◽  
Joanne Minford ◽  
Sarah Almond

Abstract The diagnostic uncertainty for children with abdominal pain has increased during the COVID-19 pandemic with the additional consideration of both COVID-19 and paediatric inflammatory multisystem syndrome—temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS) alongside appendicitis, mesenteric adenitis and other less common causes of abdominal pain. We describe the cases of two children who presented with severe abdominal pain, non-bilious vomiting and high temperatures during the UK’s first peak of the COVID-19 pandemic. Laboratory and abdominal ultrasound features were similar for both children but symptom progression in combination with cross-sectional abdominal imaging enabled differentiation between PIMS-TS and appendicitis with concurrent COVID-19. These cases highlight the importance of regular clinical review, multidisciplinary working and the utility of early cross-sectional imaging to determine the underlying condition.


2020 ◽  
Vol 18 (4) ◽  
pp. 396-400
Author(s):  
K. Georgiev ◽  
Kr. Kalinova

Mesenteric lymphadenitis is a disease that pediatric surgeons face on a daily basis due to symptoms resembling the symptoms of acute appendicitis. 45 children with abdominal pain were examined for the last 3 years, aged 3 to 18 years, treated non-surgically, and proven laboratory, microbiological and instrumental diagnosis. Mesenteric lymphadenitis is a very common diagnosis in children with suspected acute appendicitis. In previous methods, based solely on age and location, there were many difficulties in identifying the etiology of acute abdominal pain in children. We decided to develop a new systematic classification of acute abdominal pain. Carrying out a clinical and epidemiological analysis of the diseased children with acute surgical diseases in order to establish a pre-operative imaging and laboratory diagnosis, to establish the sensitivity of microbiological markers An overview of the literature on the topic has been made


2018 ◽  
Vol 5 (6) ◽  
pp. 2283
Author(s):  
Balaji Dhanaram ◽  
Sakthivel Chandrasekar ◽  
Baskar Muthukumaraswamy

Background: Abdominal pain is a very prevalent problem in children and one of the common causes for visit to the hospital. They may be of acute or chronic presentation and depending on severity may also require admission to hospital.Methods: This is a retrospective study conducted in our hospital over a period of 3 years. About 200 children who came to the hospital with abdominal pain and received treatment in surgical outpatient or referred to surgery department from emergency were included in this study and all relevant data were collected.Results: The pain was found to be more in boys and in the age group of 9 to 12years. The most common cause was found to be mesenteric adenitis followed by acute appendicitis. About 38% of children required surgical intervention on that admission due to various surgical causes.Conclusions: The database of our retrospective study regarding age and sex incidence, clinicopathological features and therapeutic outcome was comparable to other studies in various literatures.


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