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Mesenteric adenitis and acute terminal ileitis: US evaluation using graded compression.

J B Puylaert

    Radiology
    |December 1, 1986
    PubMed
    Summary
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    Ultrasound can help differentiate appendicitis from other conditions. Enlarged lymph nodes and thickened ileum suggest mesenteric adenitis, not appendicitis, avoiding unnecessary surgery.

    Area of Science:

    • Gastroenterology
    • Diagnostic Imaging
    • Pediatric Surgery

    Background:

    • Acute appendicitis is a common surgical emergency.
    • Differentiating appendicitis from other causes of abdominal pain can be challenging.
    • Ultrasound is frequently used in the diagnosis of acute appendicitis.

    Purpose of the Study:

    • To evaluate ultrasound findings in patients with suspected acute appendicitis.
    • To identify specific ultrasound features indicative of conditions other than appendicitis.
    • To guide appropriate clinical management and surgical decisions.

    Main Methods:

    • One hundred seventy patients with suspected acute appendicitis underwent ultrasound examination.
    • Graded compression technique was utilized by the examiner.

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  • Findings were correlated with surgical and barium study results where applicable.
  • Stool cultures were performed in a subset of patients.

    • Main Results:

    • Fourteen patients presented with enlarged mesenteric lymph nodes and mural thickening of the terminal ileum on ultrasound.
    • These 14 patients did not have appendicitis.
    • Eight of nine stool cultures were positive for Yersinia enterocolitica.
    • These findings were consistent with mesenteric adenitis and acute terminal ileitis.

    Conclusions:

    • Ultrasound findings of enlarged mesenteric lymph nodes and terminal ileum mural thickening suggest mesenteric adenitis and acute terminal ileitis.
    • Appendectomy should be avoided in such cases.
    • Accurate ultrasound interpretation is crucial for appropriate diagnosis and management.