Mesenteric lymphadenopathy in children with chronic abdominal pain

Background: Mesenteric lymphadenopathy is a common finding described by abdominal ultrasonography in children. Objective: To estimate incidence and significance of mesenteric lymphadenopathy (MLN) in children with chronic abdominal pain (CAP) as compared to healthy children. Method: A prospective observational study was conducted in the paediatric department of a tertiary care hospital. Cases included children of age group 5-15 years with CAP who were subjected to abdominal ultrasonography during the study period. Controls included children in whom abdominal sonography was performed for reasons other than abdominal pain. Descriptive statistics were used for the analysis of baseline characteristics of the study group. For the variables following normal distribution curve, mean and standard deviation were computed. The presence of enlarged nodes, their location, size and other significant findings were recorded. Pearson's Chi-square test was used to analyse categorical variables between groups. Results: Three hundred and eighteen children were enrolled in the study. After excluding those who did not meet the criteria, the final study population included 110 cases and 138 controls. CAP was almost equal in both sexes with male: female ratio of 1:1.07. Mesenteric lymph nodes were detected by ultrasonography in 84 (72.1%) cases and in 41 (13.4%) controls. Significant MLN (≥5 mm short axis or > 10mm long axis) was present in 62 (56.4%) of 110 children with CAP, in contrast to 16 (11.6%) of 138 controls (p < 0.001). Most common location of the nodes was in the right iliac fossa (79%) followed by peri-umbilical location (77.4%).Conclusion: MLN, with lymph nodes more than 5mm on their short axis, is a significant finding in children presenting with CAP.