Correlation of Mesenteric Lymphadenitis Diagnosed by Ultrasound with Abdominal Pain in Pediatric Patients: A Prospective Observational Study

Abstract

Background: Mesenteric lymphadenitis is the inflammation of mesenteric lymph nodes, and is a frequent but often underdiagnosed cause of acute abdominal pain in children. It can be easily mistaken for acute appendicitis, which can result in unnecessary interventions. Because of its non-invasive, cost-effective, and radiation-free characteristics, ultrasound has become the imaging modality of choice, and the main criterion for the diagnosis is the short axis of the lymph nodes greater than 5 mm. Designing the study: A retrospective study of all children aged 0 to 19 with acute abdominal pain who underwent mesenteric lymphadenitis and underwent sonographic evaluation of the disease. Retrospective study of all children (0-19 years) with acute abdominal pain who were evaluated for mesenteric lymphadenitis and who had sonography performed. Methods: The study was a prospective observational study and included 100 children aged 5-16 years attending a private paediatric diagnostic imaging practice between January and August 2025. Demographic data, number of lymph nodes, size (long- and short-axis) and localization were systematically collected for all participants, who were subjected to high-frequency abdominal ultrasound. Results: Mesenteric lymphadenitis occurred in 67% of patients. The epigastric area was the most common area of involvement (76.5%). Largest lymph nodes were found to be 12-15 mm in the long axis and 5-7 mm in the short axis. 41% of patients presented within 24 hours of symptom onset. Discussion: Ultrasound is a safe and effective way to diagnose children with mesenteric lymphadenitis, which avoids unnecessary surgeries like appendicitis and helps differentiate the condition.