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Acute nonspecific, or primary, mesenteric lymphadenitis is a self-limiting inflammatory condition affecting the mesenteric lymph nodes, whose presentation mimics appendicitis or intussusception. It typically occurs in children, adolescents, and young adults. White blood count and C-reactive protein are of limited usefulness in distinguishing between patients with and without mesenteric lymphadenitis. Once the diagnosis is established, supportive care including hydration and pain medication is advised.
Furthermore, it is crucial to reassure patients and families by explaining the condition and stating that affected patients recover completely without residuals within 2—4 weeks. Textbooks generally consider this rather common condition no more than a medical curiosity, which is essential exclusively from the standpoint of differential diagnosis with appendicitis and intussusception. Recently performed imaging studies among subjects with suspected appendicitis or intussusception confirm that acute mesenteric lymphadenitis is the most frequent alternative diagnosis [ 3 , 4 ].
Although liberal use of high-quality imaging studies now better characterizes mesenteric lymphadenitis, its natural history and appropriate management have not been clearly defined. The purpose of this report is to summarize available information even if limited and guide practicing physicians faced with this condition. For a long time, enlarged mesenteric lymph nodes in the young were considered invariably due to tuberculosis. A few years after the First World War, the existence of a mesenteric lymphadenitis, as an independent clinical entity of nontuberculous origin, was recognized [ 5 ].
At that time, a definite diagnosis of mesenteric lymphadenitis was very difficult to make before surgery [ 5 ]. Initially, surgical management of mesenteric lymphadenitis with appendectomy was advised by some. Very soon, however, it was recognized that there is no reason to believe that appendectomy affects the disease course, which in any case is self-limiting and from which ultimate recovery seems to be invariable [ 5 , 6 ]. Many physicians currently consider mesenteric lymphadenitis a nondisease and its symptoms unexplained.
