In mesenteric adenitis, children present with fever and abdominal pain, which is diffuse or localized to the right lower quadrant. Tenderness is frequently elicited over the McBurney's point, and appendicitis is strongly suspected on a clinical basis. At surgery, the terminal ileum is thickened and shiny with enlarged mesenteric lymph nodes, which may appear necrotic. The appendix is normal or only mildly inflamed. Therefore, this would be a diagnosis of exclusion and is high on the differential diagnosis. In comparison to appendicitis, the pain may be more diffuse and the site of tenderness may shift when the patient's position changes. In appendicitis, the location of the tenderness tends to be fixed.
(Behrman: Nelson Textbook of Pediatrics, 16th ed., Chapter 201 - Yersinia.
Thomas G. Cleary. Copyright © 2000 W. B. Saunders Company, p 859)
(Mesenteric Adenitis. Last updated: April 26, 2002 e-Medicine.com. Brian Burke MD and Micha Ziprkowski MD)
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