Acute mesenteric lymphadenitis is characterized by inflammation of the mesenteric lymph nodes predominantly of the ileocolic group.

Incidence

It commonly affects children or young adults.

Etiology

The cause is an infection with Yersinia pseudotuberculosis, Yersinia enterolitica, or adenovirus.

Symptoms

The clinical picture resembles acute appendicitis.
It presents with periumbilical pain associated with high fever.
Vomiting is rare.

Signs

The tender point is usually in the right iliac fossa in the supine position, and moves to the left if the patient is made to lie down on the left side and vice versa (“Klein’s sign”).
Muscular defense is predominantly not present.
In thin children, enlarged lymph nodes can be palpated.

Differential diagnosis

Acute appendicitis.
Tuberculous infection

Investigations

Clinical suspicion is important in the diagnosis.
Abdominal ultrasound and CT may show enlarged mesenteric lymph nodes.

Treatment

Medical management with antibiotics and supportive measures.