Although the symptoms of paediatric acute mesenteric lymphadenitis are similar to those of appendicitis, the condition is usually milder and has the following characteristics.
A child with a recent acute upper respiratory infection such as a cold, pharyngitis, tonsillitis or an inflammatory bowel condition such as diarrhoea or vomiting.
short duration of abdominal pain episodes, usually temporary relief after half an hour to two hours, the child feels well between abdominal pain episodes, there is no abdominal muscle tightness during abdominal pain and the pain does not shift in location (abdominal pain in acute appendicitis is characterised by metastatic right lower abdominal pain).
Fever usually below 38.5°C.
a swelling that can be felt in the child’s neck or lower right abdomen, suggesting possible lymph node enlargement
A routine blood test reveals a normal or only slightly elevated white blood cell count (in acute appendicitis the white blood cells are significantly elevated).
These conditions suggest that acute mesenteric lymphadenitis is likely in children.
Sometimes it remains difficult to differentiate by various methods and the doctor will observe the child for as short a time as the child’s condition allows. After treatment with fasting, intravenous fluids and antibiotics, the abdominal pain caused by mesenteric lymphadenitis may improve significantly; if it does not improve after treatment, it may suggest appendicitis or other disease, and the doctor will perform surgical exploration to distinguish between the two if necessary.