Question
My son has always had a large appetite since he was little. Recently, for the past two days, he might have eaten something cold, and he often feels stomach pain, a bit nausea, vomiting, and diarrhea. After going to the hospital for a check-up, the doctor said it was mesenteric lymphadenitis and prescribed several days of symptomatic anti-inflammatory medication to take, as well as intravenous fluid therapy. After a few days of treatment, his stomach pain has decreased. I would like to get some help: how to deal with pediatric mesenteric lymphadenitis?
Answer
If diagnosed, conservative treatment can be pursued. Generally, after fasting, intravenous fluid therapy, and antibiotic treatment, abdominal pain can significantly improve and gradually recover, without the need for surgery. However, if the symptoms do not improve after the aforementioned treatment or if it is difficult to distinguish from acute appendicitis, surgical exploration is recommended. In cases caused by Salmonella, if abscesses form or peritonitis symptoms appear, surgical drainage should be performed. Some children may have an intestinal intussusception as a complication, so attention should be paid to observation. Gastrointestinal diseases caused by Salmonella infection are most commonly gastritis, but there are also reports of acute mesenteric lymphadenitis. Mesenteric lymphadenitis caused by Salmonella infection is different from viral lymphadenitis, and it commonly affects children or adolescents. The lymph nodes affected by bacteria often show acute inflammatory reactions within the nodes, with bleeding and necrosis. Salmonella can be isolated from within the lymph nodes. Conservative treatment should be initiated first; if abscesses form or peritonitis symptoms appear, surgical drainage should be performed.