소아 장간막 림프절염의 임상적 고찰

Abstract

Purpose : Mesenteric lymphadenitis is classified into acute and chronic, specific and nonspecific types according to clinical aspect and causative disease. We under took this study to find out clinical aspects, associated diseases and hospital course of mesenteric lymphadenitis in children. Methods : We examined 98 children aged from 18 months to 14 years who visited Dongsan Medical Center for abdominal pain between March 1998 and May 2002. Ultrasonography was performed and medical records were analysed. The specific group had a causative disease, and the chronic group had persistent clinical symptom over three months. Results : Symptoms were chronic in 4% of the patients and acute in 96%. Most of the patients were in oen to five years of age. In the acute group, abdominal pain, vomiting, fever and diarrhea were shown commonly in order, and average WBC count was normal. Gastroduodenitis, tonsillitis, pneumonia and enterocolitis were accompanied in the acute specific group. Ultrasonograms of abdomens showed lymph node enlargement. In the acute group, symptoms were improved within one week. Lymph node enlargement was noted on follow up ultrasonograms in the chronic group. Gastrocolonoscopy of chronic group showed one case of H. pylori positive duodenitis, one case of ulcerative colitis, and two cases of Crohn's disease. Conclusion : There was no statistical significance in clinical aspect, laboratory findings and hospital course between the patients with specific etiology and nonspecific etiology. Symptoms improved within one week in patients in the acute group. If abdominal pain persists, additional examinations such as endoscopic biopsy, stool cultures, or small bowel studies should be performed to determine the underlying cause.