EVALUATION OF ABDOMINAL LYMPHADENOPATHY IN CHILDREN BY ULTRASONOGRAPHY

Background. There may be uncertainty as to whether enlarged abdominal lymph nodes (LNs) in children are normal or abnormal. Objective. To co mpare, by ultrasonography (US), enlarged abdominal LNs in healthy chil dren with those in children with acute abdominal pain or acute gastroe nteritis. Materials and methods. One hundred and twenty-two asymptomat ic children were selected by questionnaire and compared with 44 childr en with acute abdominal pain of unknown origin and 27 children with ac ute gastroenteritis. The number of LNs, their location, their shape an d the presence of tenderness as detected by finger compression of each LN were evaluated. The children were divided into four groups accordi ng to age: 0-2, 3-6, 7-10, and 11-15 years. Results. LNs were detected in the ileo-caecal and/or para-aortic areas in almost all of the asym ptomatic children. The number of large LNs (> 10 mm) in the para-aorti c areas was higher in the older children (greater than or equal to 7 y ears of age) than in the younger children (less than or equal to 6 yea rs of age) (P < 0.05), The number of spindle-shaped LNs (ratio of long -to short-axis diameter greater than or equal to 2.0) was increased in the older children. The number of LNs was not increased in the childr en with acute abdominal pain. The size of the LNs was largest in the c hildren with acute gastroenteritis, followed by the children with acut e abdominal pain and the asymptomatic children (P < 0.001). Although t he shape of the LNs was no different among the three groups of childre n, the frequency of round-shaped LNs (ratio of long- to short-axis dia meter < 2.0) was greater in the older children with acute abdominal pa in or acute gastroenteritis than in the asymptomatic children (P < 0.0 1). The number of LNs with tenderness detected by finger compression w as significantly greater in the children with acute abdominal pain and acute gastroenteritis than in the asymptomatic children (P < 0.0001). Conclusion. The number of large and round-shaped LNs with tenderness tended to be increased in the children with acute gastroenteritis and acute abdominal pain. There is no clear specificity of LN enlargement in the children with acute abdominal pain, and the main challenge is t o diagnose or estimate the organic pathology by US, regardless of the presence of lymphadenopathy.