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Mesenteric adenitis
Last reviewed: 19.11.2021
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Mesadenitis is an inflammation of the lymph nodes of the mesentery and intestine.
There are nonspecific (simple) and specific (tuberculous or pseudotuberculous) mesadenitis, which along the course is acute and recurrent.
How does mesadenitis appear?
It is accompanied by an increase in lymph nodes, edema of the mesentery, dilatation of the lymphatic vessels of the mesentery and small intestine.
Acute mezadenitis or exacerbation begins suddenly with the appearance of cramping or persistent pain in the epigastrium, in the navel or to the right of it (Vilna's syndrome). They last from several hours to 2-3 days, usually without progression, if there is no suppuration of the lymph nodes. There may be nausea, vomiting, hiccough, diarrhea. In a history of often recently transferred or angina in the course of, or respiratory diseases, lung pathology may occur.
The general condition is disrupted only with suppuration of the lymph nodes and the development of peritonitis.
The same applies to laboratory indicators. When palpation of the abdomen, there is a moderate soreness in the peripodal region, epigastrium, right iliac and inguinal region.
The stomach tension is expressed moderately, mainly with deep palpation, the symptom of Schetkina-Blumberg is not determined. Symptoms are: McBurney (painful points left and right below the navel); McFaden (soreness along the edge of the rectus abdominis muscle 2-4 cm below the navel); Klein (moving a painful point when turning the patient from the back to the left side); Sternberg: pain at palpation above the navel for 1-2 cm; tenderness in palpation along the line connecting the right iliac region and the left: the hypochondrium. When examining the pharynx, hyperemia, a picture of angina or tonsillitis is often noted.
When tuberculous mezadenitis through the abdominal wall, dense and knobby bundles of lymph nodes are palpable. At an auscultation of a stomach the noise of a friction of leaves of a peritoneum about tubercular tubercles (a sign of "rasp") is defined. Radiographs of the abdominal cavity determine calcified lymph nodes.
Differentiate mesadenitis with acute appendicitis (no progression), gastritis, infectious diseases (the presence of specific symptoms for them).
Tuberculous mesadenitis is differentiated with lymphogranulomatosis, Shenlaine-Henoch disease (laboratory blood test, abdominal radiography, laparoscopy).