Does your child have a stomach ache and a fever? It's not always appendicitis! (Mesenteric Lymphadenitis)

Is your little one suddenly crying because he has a stomachache? Is he struggling with a slight fever, especially when he doesn't let you touch the right side of his stomach? At a time like this, the biggest fear that comes to the mind of any mother or father is, "Oh, I don't know about appendicitis." That fear is reasonable. But it doesn't always turn out to be appendicitis. Today, we are going to talk about another condition that also shows symptoms, but is not as dangerous. We call this Mesenteric Lymphadenitis.

Simply put, what is Mesenteric Lymphadenitis?

Okay, this name may sound a little complicated, but the story is very simple. Let's break it down word by word.

• Lymphadenitis: This means "swelling of the lymph nodes." Lymph nodes are like little guards in our body's immune system. Like police. Their job is to catch germs, bacteria, and viruses that enter the body and stop them from spreading throughout the body. So when we fight a germ, these nodes swell and become painful. Just like the lymph nodes in our neck swell.
• Mesenteric: This refers to the location of these glands. The intestines inside our stomach are kept in one place without floating around, but are arranged in a neat manner by a membrane called "Mesentery" . The intestines are connected to the abdominal wall like a curtain. So, swelling of the glands around this membrane is called Mesenteric Lymphadenitis .

Simply put, this is inflammation caused by a bacterial infection in the stomach and intestines.

Who is most likely to develop this condition?

This is most often seen in young children and young adults , especially those under the age of 20. It is very rare in adults.

Why do children get them more often? Because children's immune systems are still developing and they are constantly exposed to various viruses and bacteria, their body's immune systems are constantly active. Therefore, even with a minor infection, these immune systems are more likely to become inflamed.

What are the symptoms? Why is this confused with appendicitis?

This is where the most important and scary part lies. Because the symptoms of this disease are very similar to those of appendicitis. The reason for this is that a large number of these cysts are located very close to the appendix, which is where appendicitis occurs, in the lower right part of the abdomen.

Let's take a look at these similarities and some of the minor differences in the table below.

Why do these bumps swell? What are the causes?

The main reason for this is an infection. That is, a germ enters the body and our immune system fights against it.

Due to infections

Most often this is due to a viral infection .

• Gastroenteritis: This is a condition that we commonly call "stomach flu," which causes vomiting and diarrhea. Because this virus affects the intestines, the lining around them can become inflamed.
• Respiratory tract infections: This condition can also be caused by something like a common cold or a throat infection.

Sometimes this can also be caused by bacterial infections .

• Yersinia enterocolitica: This is the main bacteria. It is transmitted through undercooked meat, especially pork, and contaminated water.
• Other bacteria: These glands can also become swollen in conditions such as tuberculosis or HIV infection.

Due to other medical conditions

Very rarely, these bumps can also be a symptom of other medical conditions. For example, in conditions like cancer (Lymphoma) and Inflammatory Bowel Disease. But these are very rare, so there is no need to worry.

How do you find this, Doctor?

When you take your child to a doctor, the first thing he or she will do is ask you some questions.

• "When did the trouble start?"
• "Where is the pain?"
• "Did you vomit? Is your stomach upset?"
• "Did you have a cold before this problem came?"

Then the doctor examines the child, especially the abdomen , looking for any painful areas and any swelling of the nipples.

Next, it's important to make sure it's not appendicitis, because appendicitis is a condition that requires emergency surgery. To confirm this, your doctor may order these tests:

• Blood test (Complete Blood Count - CBC): Checks for infection in the body.
• Ultrasound Scan: This is the most commonly used method. It can clearly see if the appendix inside the abdomen is swollen or if appendicitis is present.
• CT Scan: Sometimes, if the ultrasound scan is not clear, a CT scan may be ordered.

What are the treatments? What can I do at home?

Here's the good news. For most children, Mesenteric Lymphadenitis resolves on its own within 1 to 4 weeks without any specific treatment. It has no long-term effects.

However, the doctor will prescribe medication to ease the child's discomfort.

• If it is a bacterial infection: If confirmed by blood reports, antibiotics will be given.
• If it is a viral infection: There is no specific medicine for it. The treatment is symptomatic. A painkiller such as paracetamol will be given for pain and fever.

There are several things you can do while taking care of your child at home.

• Rest: Let your child get plenty of rest. Reduce playing, running, and jumping for a few days.
• Fluids: Vomiting and diarrhea can cause dehydration, so give plenty of fluids like water, broth, porridge, and soup.
• Warmth on the stomach: Placing a hot water bottle or a heated cloth on the stomach may help relieve some of the pain.
• Painkillers: Give the painkillers prescribed by the doctor at the right time and in the right dosage.

Your child may not want to eat because of nausea. But try to offer small amounts of bland, low-fat, and easily digestible foods.

Can this be prevented from happening?

Yes, to some extent we can prevent this. This is caused by infections, and what we need to do is protect ourselves from infections. That means cleanliness is the most important thing.

What are the most important times to see a doctor?

If your child has any of the following symptoms, contact your doctor immediately or go to the nearest hospital's Emergency Department (ETU).

Especially remember, if an adult over 20 years of age develops these symptoms, it is very unlikely that it is Mesenteric Lymphadenitis. Therefore, it is more likely that it is appendicitis. In such a case, it is imperative to immediately refer to an Emergency Treatment Unit (ETU).

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