Mesenteric Adenitis
Basics
Inflammation of the mesenteric lymph nodes; a common cause of self-limited right lower quadrant (RLQ) abdominal pain
Description
- Characterized by benign inflammation of the mesenteric lymph nodes; can be acute or chronic, primary or secondary
- May clinically mimic acute appendicitis
Epidemiology
- Commonly misdiagnosed, making definitive incidence difficult to determine
- Most common cause of appendicitis-like pain in children (1)
- More common in children <15 years old than in adults
- Primary adenitis is more common in children.
- Secondary adenitis is more common in adults.
- Rule out diverticulitis, appendicitis, Crohn disease, or systemic infectious/inflammatory disease (e.g., HIV, SLE, sarcoidosis).
Prevalence
Affects males and females equally
- Adenitis secondary to Yersinia infection is more prevalent in boys than girls.
- Yersinia enterocolitica is most common in North America, Eastern Europe, and Australia.
Etiology and Pathophysiology
- Primary: underlying inflammatory process not present; presumed due to acute infectious gastroenteritis (specifically, terminal ileitis)
- Secondary: underlying inflammatory process present
- In infectious cases, pathogens are ingested, translocate through the intestinal epithelium via Peyer patches, and gain access to mesenteric lymph nodes where an inflammatory reaction causes symptoms and clinical disease:
- Y. enterocolitica
- Campylobacter jejuni
- Salmonella typhi
- β-Hemolytic Streptococcus spp.
- Staphylococcus spp.
- Streptococcus viridans
- Escherichia coli
- Mycobacterium tuberculosis
- Giardia lamblia
- Epstein-Barr virus (EBV) (mononucleosis)
- Acute HIV infection
- Rubeola virus
- Bartonella henselae (cat-scratch disease)
- Adenovirus species
- Toxoplasma gondii
Genetics
No known genetic susceptibility
Risk Factors
- Typically preceded by URI or pharyngitis
- History of ingesting undercooked pork particularly in areas where Yersinia is endemic (parts of Europe)
General Prevention
Minimize risk by fully cooking foods, especially meat.
Commonly Associated Conditions
- Appendicitis
- Diverticulitis
- Crohn disease
- Celiac disease
- Other systemic inflammatory/autoimmune disease
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Citation
Domino, Frank J., et al., editors. "Mesenteric Adenitis." 5-Minute Clinical Consult, 33rd ed., Wolters Kluwer, 2025. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688212/0.0/Mesenteric_Adenitis.
Mesenteric Adenitis. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2025. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688212/0.0/Mesenteric_Adenitis. Accessed December 1, 2024.
Mesenteric Adenitis. (2025). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (33rd ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688212/0.0/Mesenteric_Adenitis
Mesenteric Adenitis [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2025. [cited 2024 December 01]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688212/0.0/Mesenteric_Adenitis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Mesenteric Adenitis
ID - 1688212
ED - Domino,Frank J,
ED - Baldor,Robert A,
ED - Golding,Jeremy,
ED - Stephens,Mark B,
BT - 5-Minute Clinical Consult, Updating
UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688212/0.0/Mesenteric_Adenitis
PB - Wolters Kluwer
ET - 33
DB - Medicine Central
DP - Unbound Medicine
ER -