- Mesadenitis symptoms
- Mesadenitis reasons
- Treatment of the Mesadenitis
Mesadenitis (annate. mes [enterium] a mesentery + Greek aden of iron + - itis; synonym: mezenteralny lymphadenitis, a mesenteritis) — an inflammation of lymph nodes of a mesentery of intestines.
The mesadenitis is subdivided on nonspecific (simple and purulent), tubercular and pseudotuberculous. On the clinical course of process distinguish an acute and chronic (recurrent) mesadenitis.
Beginning acute nonspecific mezadeniye, as a rule, sudden. There is colicy or constant pain which is localized in a navel or to the right of it which proceeds from several hours to 2 — 3 days. Along with it fervescence, increase of pulse, a hiccups, nausea, vomiting, a diarrhea or a lock, sometimes a hyperemia of a pharynx, person, a herpes simplex are noted. In the anamnesis often there are instructions on recently postponed flu or quinsy. The general condition of patients, as a rule, remains satisfactory. It significantly worsens only at the purulent mesadenitis which is often proceeding with the expressed intoxication. At the same time usually define the leukocytosis reaching 30×109/л and a deviation to the left. Find also a hypoalbuminemia and increase in globular fractions at the expense of g-globulin. At a chronic mesadenitis are noted short-term, uncertain localization of an abdominal pain, periodically there is a diarrhea or a lock. Against the background of chronic process the aggravation with clinical symptomatology of an acute mesadenitis is possible.
The palpation of a stomach reveals morbidity and a muscle tension in the right ileal and inguinal areas; symptoms of irritation of a peritoneum can be limited or diffuse, depending on a mesadenitis form. Are characteristic of a mesadenitis Mac-Faddena's symptom — morbidity on edge of a direct muscle of a stomach 2 — 4 cm lower than a navel; Klein's symptom — movement of a painful point from right to left at turn of the patient from a back on the left side; Shternberg's symptom — morbidity at a palpation on the line connecting the right ileal area to the left hypochondrium. The diagnosis is confirmed by means of a laparoscopy. Ultrasound examination of abdominal organs and a computer tomography have great diagnostic value. However the correct diagnosis is more often establish only as a result of an intraoperative biopsy of mezenterialny lymph nodes.
Etiogoliya and pathogeny of a nonspecific mesadenitis are finally not found out. Contagiums can get into lymph nodes of a mesentery of intestines in the enterogenous and limfogematogenny way from various primary centers located, for example, in a worm-shaped shoot, intestines, upper respiratory tracts, lungs, etc.
Macroscopically at nonspecific the mesadenitis is usually noted hypostasis of a mesentery of a small bowel in which, more often in the field of an ileocecal corner, the increased lymph nodes of a soft consistence are found. At a purulent mesadenitis on site of lymph nodes infiltrate with a necrosis and purulent fusion is formed. Histologically in lymph nodes of a mesentery of intestines the lymphoid hyperplasia, leukocytic infiltration come to light. Progressing of process can be followed by inflammatory infiltration of fatty tissue of a mesentery of intestines.
Treatment of the Mesadenitis:
Treatment of an acute nonspecific mesadenitis conservative; the rest, antibiotics desensibilizing means, physiotherapeutic procedures, perinephric blockade. At a wedge, the laparotomy is shown to a picture of an acute abdomen. If it is carried out concerning an estimated acute appendicitis, then operation is finished, as a rule, with removal of a worm-shaped shoot and a biopsy of a lymph node. Enter novocaine solution with antibiotics into a mesentery of a small bowel. At a purulent mesadenitis open and drain an abscess cavity. In the postoperative period appoint antibiotics, physiotherapeutic procedures.