MESENTERIC ADENITIS CAUSED BY YERSINIA-PSEUDOTUBERCULOSIS PRESENTING AS AN ABDOMINAL-MASS

Infection by Yersinia pseudotuberculosis has become of increasing path ological importance. Patients normally present with symptoms similar t o those of appendicitis, due to mesenteric adenitis. We present the ca se of 3 patients infected by Yersinia pseudotuberculosis who in additi on to fever and abdominal pain had a palpable abdominal mass, so great was the enlargement of the mesenteric nodes. In 2 patients a laparoto my was carried out, followed by biopsy of a mesenteric lymph node. The diagnosis of Yersinia infection was confirmed by bacterial culture of the biopsied material and also by serology. In the third patient, ser ological studies and ultrasonic imaging of the abdomen led to early di agnosis and surgery was avoided. We suggest that a diagnosis of mesent eric adenitis due to Yersinia pseudotuberculosis should now be conside red in all patients presenting with an abdominal mass, and in whom the re is an appropriate clinical and epidemiological history. The diagnos is should be confirmed by abdominal ultrasound (alternatively Computer ised Axial Tomography or Magnetic Resonance Imaging) and serological s tudies. In this way, unnecessary surgery can be avoided.