Mesenteric lymphadenitis
Background
- Inflammation of mesenteric lymph nodes
- Frequently mistaken for appendicitis
Clinical Features
- RLQ pain, frequently confused with appendicitis
Differential Diagnosis
RLQ Pain
- Appendicitis
- Abdominal aortic aneurysm
- Crohn's disease (terminal ileitis)
- Diverticulitis (cecal, Asian patients)
- Ectopic
- Endometriosis
- Epiploic appendagitis
- Herpes zoster
- Inguinal hernia
- Ischemic colitis
- Kidney stone
- Meckel's diverticulum
- Mesenteric lymphadenitis
- Mittelschmerz
- Neutropenic enterocolitis (typhlitis)
- Ovarian cyst
- Ovarian torsion
- PID
- Pyelonephritis
- Psoas abscess
- Testicular torsion
Evaluation
- Frequently found on abdominal CT (when ruling out appendicitis)
Management
Uncomplicated/mild
- Supportive care (do NOT require antibiotics)
Mod-severely ill
- Cover for Yersinia
- Ciprofloxacin and/or TMP-SMX
Disposition
Normally discharged home, unless:
- Significant volume depletion
- Significant electrolyte imbalance
- Sepsis
See Also
External Links
References
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