Clinico-Radiological Profile of Abdominal Pain in Children Admitted in a Tertiary Care Centre-A Retrospective Cohort Study

Abstract

Background and Aim: Mesenteric lymphadenitis in pediatric population usually presents with abdominal pain mimicking appendicitis mounting a challenging task for physicians to diagnose. It is a self-limiting inflammatory process and resolves spontaneously. In addition to clinical features, ultrasonography is the primary diagnostic modality. We aimed to evaluate the clinico-radiological characteristics of mesenteric adenitis in patients presenting with abdominal pain. Materials and Methods: A total of 108 patients attending paediatric out-patient and paediatric surgery clinic in Saveetha Medical College and Hospital, Chennai, between January 2018 and December 2020 with abdominal pain for several aetiologies were included in this study. The clinical presentation, laboratory parameters and the ultrasonographic findings were noted. Data summarized as numbers, percentages and Mean ± Standard Deviation (SD). Results: Peak prevalence was found to be at around 8 [range 6-10] years. Clinically, 58.3% had fever, 40.7% had dysuria and 36.1% had diarrhoea. Laboratory parameters were non-specific for this condition. Majority of the enlarged lymph nodes were found in the right lower quadrant (81.5%) followed by (10.2%) in the para-umbilical region and (8.3%) in left lower quadrant. Conclusions: Mesenteric lymphadenitis as an individual clinical entity is a very challenging task for the paediatricians to evaluate and diagnose due to several possible variations in the clinical presentation. Although mesenteric lymphadenitis is usually a self limiting entity, a cohort of children warrant medical interventions.