Aetiological Outcome of Mesenteric Lymphadenopathy and Pain Abdomen in Paediatric Population at a Tertiary Care Hospital (MRIMSHyderabad) - A Hospital Based Prospective Observational Study

Abstract

BACKGROUND Abdominal pain is a common disorder in children and adolescents worldwide with prevalence rate ranging from 20 - 25 % in school-going children in India. It is a frustrating concern to the child, parents and the physician. Even though abdominal pain is one of the most common complaints in children, it poses a diagnostic challenge owing to the variety of underlying causes. The purpose of this study was to evaluate the aetiology of abdominal pain associated with significant mesenteric lymphadenopathy in a paediatric population. METHODS This is a hospital based prospective, observational study done in Department of Paediatrics, Malla Reddy Institute of Medical Sciences (MRIMS), Hyderabad. RESULTS Out of the 65 children studied, 30.8 % were of 5 - 8 years age group, 36.9 % were 9 - 12 years age group and 32.3 % were 13 - 15 years age group. In our study, we found 50.8 % were boys and 49.2 % were girls. 20 % of them were having fever, 16.9 % were having cough, 16.9 % were having diarrhoea, 13.8 % were having sore throat, 16.9 % dysuria, and 15.4 % were having constipation. All patients in our study group underwent ultrasound of abdomen. All cases were having significant mesenteric lymphadenopathy (more than 5 mm in short axis with three or more number of lymph nodes). In 53.8 % cases, etiological agent for the mesenteric lymphadenopathy was not proved with our investigations. In the remaining 46.2 % of children, cause of mesenteric lymphadenopathy was proved and 38.5 % were bacterial infections, 6.2 % were viral infections and 1.5 % were parasitic infections. CONCLUSIONS It is important to recognise mesenteric lymphadenitis as a clinical entity in paediatric cases presenting with abdominal pain. They should be evaluated for an etiological agent and if no proven source of infection and etiological agent is found, it can be considered as functional abdominal pain. If we are able to get a proper etiological diagnosis in these cases, we could treat them and we could make huge difference in terms of quality of life. KEYWORDS Abdominal Pain, Mesenteric Lymphadenitis, Ultrasound, Significant Mesenteric Lymphadenopathy