Dileep Kumar Allagadda1, Harikrishna Appana2, Ramu Pedada3, Deepika Gurram4, Ditin Joseph5
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.
