복통 환아의 초음파검사에서 관찰되는 장간막 림프절

Abstract

요 약 복부 초음파검사에서 장간막 림프절 검사가 가능하였던 142명의 환아(평균 6세 5개월)들을 대상으로 복통을 호소하는 소아들의 초음파검사에서 관찰되는 복부 림프절의 임상적 의의를 양성 질환을 중심으로 알아보고자 하였다. 91명은 복통을 주소로 하였고(복통군), 51명은 복통과 관계없이(비복통군) 복부 초음파검사를 실시하였다. 초음파검사는 장경 1cm 이상 크기의 림프절의 수를 측정하였다. 환아들의 진단명과 초음파 검사 당일을 전후로 2일 이내에 해당하는 백혈구 수치를 기록하였다. 복통군과 비복통군간의 림프절비대의 빈도와 백혈구 수치와의 상관 관계, 림프절 비대 빈도와 진단명과의 상관관계 등을 분석하여 통계학적으로 의의가 있는지 분석하였다.

The purpose of this study was to evaluate the clinical significance of mesenteric lymph nodes in children presented with abdominal pain by using ultra sonography (US), focusing on benign diseases. We prospectively performed abdominal US of 1442 children (74 boys and 68 girls, Mean age, 6 years and 5 months) during recent one year. The children investigated were divided into abdominal pain (n=91) and non-pain (n=51) groups. We recorded the number of lymph nodes larger than 1cm in diameter, and also reviewed the medical records of the patients, focusing on the final clinical diagnosis and the WBC counts within 2 days of US scans. We analyzed the statistical significance of differences in the number of enlarged mesenteric lymph nodes between the pain and non-pain groups and between infectious and non-infectious diseases, and evaluated a correlation between the number of mesenteric lymph nodes and WBC counts. The pain group consisted of mesenteric lymphadenitis (12), enteritis (9), non-abdominal infectious diseases (6) and non-specific abdominal pain (64). The non-pain group consisted of urinary tract infection (17), Kawasaki disease (7), cervical lymphadenitis (8), chronic hepatitis (3), non-recurrent tumor follow-up (7), and others (19). No statistically significant difference in mean numbers of mesenteric lymph nodes was found between the pain (3.0) and non-pain (4.02) groups. The infectious disease (4.96) revealed significantly increased numbers of mesenteric lymph nodes, compared with the non-infectious diseases (2.46). Statistically significant correlation was present between the number of mesenteric lymph nodes and WBC counts. Numbers of mesenteric lymph nodes in abdominal US showed poor correlation to the presence or absence of abdominal pain in children. However, numbers of mesenteric lymph nodes tended to be related to frequency and increase of infectious diseases in the patients with leukocytosis.