Mesenteric lymphadenitis
Classification according to ICD-10 | |
---|---|
A04.6 | Enteritis due to Yersinia enterocolitica |
I88.0 | Nonspecific mesenteric lymphadenitis |
ICD-10 online (WHO version 2019) |
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
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
- M. Burdelski: Mesenteric lymphadenitis. In: Karl-Heinz Niessen: Pediatrics. Thieme, Stuttgart 2001, ISBN 3-13-113246-9 . limited preview in Google Book search
Web links
- Irene Mlekusch: Unclear abdominal pain in childhood. DD lymphadenitis. In: Österreichische Ärztezeitung. September 25, 2011.