Mesenteric adenitis

Mesenteric adenitis is a common cause of abdominal (tummy) pain in children.

It is caused by swelling (inflammation) of the glands (lymph nodes) in the abdomen that may cause pain, vomiting, and/or fever. The name comes from “mesentery”, which is where the lymph nodes are in the abdomen. Lymph nodes play an important role in our body’s immune system which fights infection. Normally they are quite small (about the size of a pea) but during an infection they can become swollen and tender, causing pain.

The pain from mesenteric adenitis can be severe and often occurs in waves and is usually in the middle (near the belly button) or in the lower right-hand side of the tummy.

What causes it?

Most cases are caused by an infection (germ), usually a virus. This infection can occur anywhere, but it is usually from an upper respiratory tract infection (a common cold) or an infection within the intestinal tract. The infection leads to inflammation of the lymph nodes. However, sometimes the cause is not known.

Signs and symptoms

Common signs of mesenteric adenitis include:

• abdominal pain
• fever
• vomiting
• change in consistency or frequency of poo
• feeling tired or lack of energy
• reduced appetite

How is it diagnosed?

There is no specific test to diagnose mesenteric adenitis. It is usually diagnosed based on your child’s symptoms and an examination. A doctor or nurse practitioner will ask you and your child some questions and do a careful examination to rule out more serious causes of the abdominal pain (e.g. appendicitis). Sometimes tests might be recommended to look for other causes of abdominal pain. These could include a urine test, ultrasound, or blood test but not every child needs these.

Treatment

Mesenteric adenitis usually gets better on its own. Treatment is focused on making your child feel as comfortable as possible while this happens. Typically, symptoms improve after a few days but may come and go and can last for up to four weeks in some cases.

Pain relief such as paracetamol (Dymadon, Panadol) and ibuprofen (Nurofen, Brufen) should make your child feel better but might not take the pain away completely. A heat pack or warm bath may also be helpful. Your child will be more tired than usual, so it’s important that they rest until they feel better.

It is important that your child remains hydrated, particularly if they are vomiting or have diarrhoea. Give your child regular, small sips of fluids that contain a balance of salts and sugars (such as oral rehydration solutions or diluted apple juice).

When to seek help

See your GP or a doctor if your baby has any of the following:

• New symptoms such as vomiting dark green or back pain.
• Worsening symptoms, including pain not able to be managed at home, increasing lethargy, or refusing to drink.
• Testicular pain.
• Blood in the stool.
• Signs of dehydration (cool and/or mottled skin, drowsy, dark urine, faint/dizzy, dry lips/tongue).

In an emergency, call Triple Zero (000) and ask for an ambulance.

If you're not sure whether to go to an emergency department, call 13 HEALTH (13 43 25 84) and speak to a registered nurse.

Developed by the Emergency Department, Queensland Children's Hospital. We acknowledge the input of consumers and carers.

Resource ID:  FS278 Reviewed: November 2023.

Disclaimer: This information has been produced by healthcare professionals as a guideline only and is intended to support, not replace, discussion with your child’s doctor or healthcare professionals. Information is updated regularly, so please check you are referring to the most recent version. Seek medical advice, as appropriate, for concerns regarding your child’s health.