Mesenteric adenitis

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Right iliac fossa pain. Suspected urinary tract stones?

Patient Data

Age: 11 years
Gender: Female
ct

Multiple enlarged mesenteric lymph nodes are seen clustered at the right iliac region anterior to the psoas muscle. The largest measures 11 mm in short axis.

Normal CT appearance of the appendix with clear surrounding fat planes.

No evidence of urolithiasis.

Annotated image

Multiple enlarged mesenteric lymph nodes are seen clustered in the right iliac region anterior to the psoas muscle (yellow circles).

Normal CT appearance of the appendix with clear surrounding fat planes (red arrow).

Case Discussion

Mesenteric adenitis is a self-limiting inflammatory process that affects the mesenteric lymph nodes in the right lower quadrant and is clinically often mistaken for acute appendicitis.

Mesenteric adenitis is most common in children and adolescents although it may occasionally affect adults. 

In most cases, mesenteric adenitis is self-limiting and typically abates over the course of a few weeks. 

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