Mesenteric lymphadenitis

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Classification according to ICD-10
A04.6 Enteritis due to Yersinia enterocolitica
I88.0 Nonspecific mesenteric lymphadenitis
ICD-10 online (WHO version 2019)
Ileocecal region with lymph nodes

The lymphadenitis mesenteric ( lymphadenitis mesenteric , pseudoappendicitis , Maßhoff-lymphadenitis or Crohn Maßhoff (after Willi Maßhoff, 1908-1975), Brennemann syndrome (after Joseph Brennemann, 1872-1944)) is a disease of childhood, in the mesenteric lymph nodes of the ileocecal region swell as a side effect of inflammation of the ileum ( ileitis ).

Pathogen

Yersinia enterocolitica and Yersinia pseudotuberculosis ( yersiniosis ) are possible pathogens causing specific mesenteric lymphadenitis . The unspecific mesenteric lymphadenitis is often an accompanying reaction to a viral system infection with adenoviruses , Epstein-Barr virus , cytomegalovirus or rotaviruses .

Clinical picture and diagnostics

enlarged lymph nodes in the right lower abdomen (ultrasound image)

The clinical picture is similar to that of appendicitis ("appendicitis"), which - like Crohn's disease - belongs to the differential diagnoses of mesenteric lymphadenitis. In addition to fever and tenderness in the right lower abdomen, there are often conspicuous findings in the rectal examination and a rectal- axillary temperature difference. The specific pathogen detection is occasionally possible from the stool or by detecting the increase in the antibody titre . In unspecific mesenteric lymphadenitis, other lymph node stations or the tonsils are often involved . The enlarged mesenteric lymph nodes can often be visualized with high-resolution sonography .

Therapy and Complications

Since the disease is usually self-limiting, treatment is usually not necessary. Rarely occurs intussusception as a complication , which then occasionally requires surgical treatment. The administration of antibiotics is only recommended in the case of a delayed (protracted) course of the mesenteric lymphadenitis and in immunosuppressed patients. If an appendectomy is performed under the impression of appendicitis , the course is usually uncomplicated.

literature

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