VISUALIZATION OF ENLARGED MESENTERIC LYMPH-NODES AT US EXAMINATION - CLINICAL-SIGNIFICANCE

Purpose: To identify conditions associated with enlarged mesenteric ly mph nodes in children with acute abdominal pain and determine the abil ity of US to detect associated abnormalities. Methods: Two hundred and fifty children with acute abdominal pain were evaluated for the prese nce of enlarged mesenteric lymph nodes (AP diameter > 4 mm). Additiona lly, a reference group of 50 asymptomatic children was also studied fo r the presence of enlarged mesenteric lymph nodes. Results: Enlarged m esenteric lymph nodes were noted in 35 (14%) symptomatic children and two (4%) asymptomatic children. A specific diagnosis was established i n 16/35 (46%) symptomatic children with mesenteric lymphadenopathy. Ac ute appendicitis was the most common diagnosis. The discharge diagnosi s in the remaining 19 children was abdominal pain or gastroenteritis o f unknown origin. US suggested the correct diagnosis in 12/16 (75%) ch ildren in whom a definite diagnosis was established. Histopathologic e xamination of enlarged mesenteric lymph nodes in three patients demons trated non-specific inflammatory changes. Conclusion: Enlarged mesente ric lymph nodes in children with acute abdominal pain represents a non -specific finding. Mesenteric lymphadenopathy is associated with a var iety of medical and surgical conditions in symptomatic children and is occasionally seen in asymptomatic children. Sonography is useful in e stablishing a primary diagnosis in these children.