Mesadenitis

Description:

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.

Mesadenitis symptoms:

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.

Mesadenitis reasons:

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.