Abdominal pain (in the abdomen) is quite common in both adults and children. Many try to associate them with any food or drinks consumed the day before. This reason for the development of events also takes place, but not always.
Abdominal pain can be caused by more serious factors. One of them is that the lymph nodes are enlarged in the abdominal cavity. In a child and an adult, the symptoms of this pathology are approximately the same. The difference is that a small patient sometimes does not know how to clearly explain what is wrong with him. Worried parents can associate his complaints about stomach pains with a dozen reasons that do not have a place in this case. Some even begin to self-medicate, thereby exacerbating the condition of the baby.
The article answers the questions about why the child can have enlarged lymph nodes in the abdominal cavity, how to differentiate this pathology from other problems with the digestive tract, and what treatment is required.
Lymph nodes
First, a brief overview of these small, but very important organs. The lymph node is a natural filter that helps get rid of all sorts of pathogenic agents that enter the body.
Its structure is quite complex. In general terms, the lymph node is a small (up to 50 mm maximum) pouch of a round, bean-shaped or oval shape, to which the lymph vessels are suitable (several inlets and one outgoing). Outside, the āpouchā is covered with a membrane consisting of connective tissue. Inside, it is filled with the so-called stroma, which is composed of reticular fibers. In the space between them, a large number of various types of lymphocytes is concentrated.
Lymph, slowly seeping through the reticular fibers, like through a sieve, is cleaned of all sorts of pathogenic agents that it ācollectedā in the body (bacteria, viruses, protozoa, and so on). If a person has any disease, there are too many harmful elements in the lymph. Lymph nodes no longer cope with their task and become inflamed. This symptom always indicates the presence of any pathogenic process in the body.
Examining the patient, the doctor discovers that he has enlarged lymph nodes. In the abdominal cavity in a child and an adult, there are about 600 of them. They are not located one at a time, but in groups that are vaguely similar to a bunch of grapes. The lymph nodes in the peritoneum are concentrated where the blood and lymph vessels pass - near the stomach, liver, spleen, mesentery, intestines.
Causes of inflammation
Based on the foregoing, it is easy to understand why lymph nodes in the abdominal cavity of a child are enlarged. In general, this condition is called lymphadenopathy, and inflammation of the lymph nodes specifically in the mesentery is called mesadenitis. The following reasons cause it:
- Any bacterial infection (streptococci, staphylococci, salmonella, tuberculosis, E. coli).
- Any viral infection (enterovirus, herpes).
- Helminthic invasion.
- Fungal infection.
- In rare cases, toxic poisoning.
Pathogenic elements enter the lymph nodes with blood, lymph, and also through the lumen of the tract (worms).
Sometimes an infection seeps directly from the intestines into the tissue of the lymph nodes.
What diseases is mesadenitis observed in?
Basically, there are enlarged lymph nodes in the child in the abdominal cavity due to the development of diseases in the organs near which they are located. Among them:
- Helminthiasis.
- Brucellosis.
- Hepatitis.
- Trichinosis.
- Ascaridosis.
- Echinococcosis.
- Salmonellosis.
- Mononucleosis.
But often the lymph nodes in the abdominal cavity of the child are enlarged due to the occurrence of infectious diseases that are not associated with the digestive tract. Among them:
- Flu.
- ARVI.
- Tuberculosis.
- Pneumonia.
- Herpes.
- Lupus erythematosus.
Also cause an increase in lymph nodes in the peritoneum can:
- AIDS.
- Syphilis.
- Malignant formations (metastasis in the digestive tract).
Basically, these ailments are observed in adults, but they also occur in children.
Classifications
A disease in which lymph nodes are enlarged in the abdominal cavity of a child can occur suddenly or last for years. Depending on the nature of the course, such forms are distinguished:
Depending on the number of enlarged lymph nodes, there are forms:
- Local (affects one node).
- Regional (enlarged more than one lymph node).
- Generalized (whole peritoneum affected).
According to etiology, the following forms are distinguished:
- Primary (proceeds as an independent disease).
- Secondary (occurs against a background of infections in the digestive tract, respiration, and others).
Enlarged lymph nodes in the abdominal cavity in a child: symptoms
In children, an acute form of pathology is more often diagnosed. It is characterized by a stormy manifestation. Its manifestations are as follows:
- A sharp increase in temperature.
- Complaints of abdominal pain (paroxysmal, acute, localized or blurry).
- Anxiety of children, tearfulness, moodiness.
- Vomiting
- Complaints of nausea.
- Diarrhea (this symptom often makes parents think that the child has eaten something wrong).
- Palpation of enlarged lymph nodes.
In the chronic form, all these symptoms are less pronounced. Also, with a prolonged course of the disease, in which the child has enlarged lymph nodes in the abdominal cavity, the stomach hurts in the navel or the pain spreads to the lower sections. Sometimes children can hardly explain exactly where it hurts, because the discomfort is fuzzy, palpable throughout the abdominal region.
Tuberculous mesadenitis
According to medical statistics, the increase in lymph nodes in the peritoneum is more often observed in children in the age range of 6-14 years. In view of this, the occurrence of such a condition due to the defeat of Koch sticks (tuberculosis form) is diagnosed in rare cases. It arises due to the fact that pathogenic sticks from the lungs enter the lymph, and with it are introduced into the lymph nodes of the peritoneum. In this case, the following signs of inflammation are observed:
- The child becomes indifferent to games, lethargic.
- Appetite is lost.
- Weight loss is observed.
- Concerned about a cough that does not respond to treatment with classical methods.
- The skin becomes pale.
- The temperature is between 37.1-37.3 degrees Celsius.
If, precisely because of the suspected tuberculosis, lymph nodes in the abdominal cavity of the child are enlarged, what should I do? First of all, you need to perform a test for the presence of Koch sticks in the blood. It is better known as the Mantoux reaction.
Nowadays, you can catch tuberculosis anywhere - in transport, in child care facilities, during public events. At risk are children in whom one of the family members suffers from this ailment, as well as those children who have suffered any disease or operation, after which they have decreased immunity. Parents of such children should immediately consult a doctor if the child has the above symptoms.
The difference between mesadenitis from appendicitis, gastritis and other gastrointestinal diseases
Symptoms such as abdominal pain, nausea, loss of appetite, weakness, fatigue, stool disorder (diarrhea / constipation) are observed in most diseases of the gastrointestinal tract. Therefore, it is practically impossible to make a diagnosis only on the basis of clinical manifestations. This is especially true if the patient is a small child who cannot really explain anything. The following characteristic signs can help in making a preliminary diagnosis:
- With gastritis, discomfort intensifies after eating. Also (in addition to the signs of mesadenitis listed above), flatulence, heartburn, belching can be observed in patients. With inflammation of the lymph nodes, such symptoms are absent.
- With appendicitis, sharp pains are most often localized in the right side of the peritoneum (in the iliac region). Palpation of this area causes muscle tension and increased pain. Another sign - the temperature in the rectal zone differs from that measured by the armpit by 1 or more degrees. There are a number of syndromes by which an experienced doctor can distinguish appendicitis from inflammation of the lymph nodes.
- With shigellosis (dysentery), the symptoms are very similar to the manifestation of an acute form of mesadenitis. The difference is that in the first case, patients have repeated diarrhea, accompanied by the appearance of mucus and blood in the feces.
Diagnostics
All parents must remember that it is necessary to immediately call an ambulance for the child if he has:
- A sharp increase in temperature.
- Vomiting
- Complaints of abdominal pain.
- Diarrhea.
Self-medication in such cases is unacceptable, since drugs āfrom diarrheaā or āfrom temperatureā can reduce or temporarily completely remove the symptoms, which will affect the diagnosis. As a result, the child may die.
The doctor first of all conducts a clinical examination of the patient, performs palpation of the peritoneum, various medical tests that help to rule out some diseases of the gastrointestinal tract.
In a medical institution, a child must perform a number of tests:
- Total blood count (determines the level of hemoglobin and white blood cells).
- Blood biochemical (reveals the presence of hepatitis viruses and other pathogenic microorganisms).
- Total urine (shows the number of white blood cells in it).
- Coprogram (using this analysis, the presence / absence of blood in the stool is detected).
- Mantoux test.
- Feces on worm eggs.
These studies help doctors exclude the patientās appendicitis, hepatitis, helminthiasis, and inflammation of the digestive tract.
Also, in a medical institution they check how much the child has lymph nodes in the abdominal cavity, by ultrasound. Additionally, experts examine the liver, pancreas, kidneys, bile ducts.
In cases where these studies do not give an accurate picture of the patientās condition, additional analyzes are performed:
- Roentgenography.
- Tomography (CT, MRI).
- Laparoscopy
- Fibrogastroscopy.
Therapies
If the child has enlarged lymph nodes in the abdominal cavity, treatment can be carried out at home or in a hospital. This is determined by the doctor, depending on the severity of the pathological process. In some cases, all treatment consists of bed rest, elimination of the underlying disease (for example, flu) and vitamins to strengthen the immune system. After recovery, all systems and organs gradually return to normal. This also applies to lymph nodes.
In other cases, drug therapy is carried out, which is primarily aimed at eliminating the causes of the pathology, that is, the underlying disease.
To relieve inflammatory processes in the lymph nodes, the following are prescribed:
- Tempalgin.
- "Papaverine".
- Drotaverinum.
- Ketorolac.
If inflammation of the lymph nodes is caused by intoxication, infusion solutions such as Neocompensan and its analogues are prescribed.
Also, physiotherapy may be prescribed for children, including compresses, mud applications, and UV.
When detecting enlarged lymph nodes, both children and adults are prescribed a diet (table No. 5). It excludes from the diet all foods that promote active digestion (spicy, spicy, salty and so on), fresh bread, fried, smoked, spicy seasonings.
Complications
If you do not go to the doctor immediately, as soon as the child has complaints of abdominal pain, accompanied by vomiting, diarrhea and fever, and instead self-medicates, then mesodenitis and lymphadenopathy that are not considered life-threatening can cause serious complications:
- Suppuration of inflamed lymph nodes. At the same time, the patientās condition worsens significantly: abdominal pain intensifies, the temperature rises (up to 40 degrees), and symptoms of severe intoxication appear.
- Peritonitis (inflammation of the peritoneum).
- Localized mesadenitis develops into generalized (throughout the body).
- Sepsis. This is one of the most dangerous complications that occur when pathogenic microorganisms enter the bloodstream.
The child has enlarged lymph nodes in the abdominal cavity and spleen
In the human peritoneum, in its upper left, is a small organ called the spleen. In the fetus, it is an organ of hematopoiesis. In a newborn baby and later on until the end of a personās life, the spleen performs many important functions, including lymphopoiesis. This means that lymphocytes and antibodies are produced in it. It also serves, like the lymph nodes, as a natural filter that traps pathogenic agents (bacteria, viruses, foreign particles).
If the child has a stomach ache, ultrasound enlarged the lymph nodes in the abdominal cavity and spleen - this is a sign that the body is undergoing an inflammatory process caused by infection by pathogenic microbes or protozoa.
However, an enlarged spleen can mean another unpleasant disease - lymphoma. It is diagnosed in people of any age, including children. Other names for the pathology are lymphogranulomatosis, Hodgkin's disease.
Its characteristic features are that at the first stages, enlarged lymph nodes practically do not manifest themselves and are detected only by chance, for example, with ultrasound of the abdominal cavity. They can spontaneously increase and decrease, without causing the patient unpleasant sensations. With the development of the disease, symptoms appear such as fever, weight loss, refusal to eat, sweating at night, abdominal pain. Inflamed lymph nodes and the spleen cease to fulfill their main function - protection against germs. Therefore, in people with such a pathology, immunity is sharply reduced.
The reason for the enlargement of the spleen is the presence in the blood of the Epstein-Barr virus (herpes 4). It is found in approximately 50% of children over 5 years of age, but not everyone gets lymphoma. Provoking factors are conditions that reduce immunity (diseases, operations, stress, poor nutrition), and a genetic predisposition.
The methods of treatment depend on the degree of development of the disease. In the early stages, antiviral therapy is prescribed using the drugs "Valacyclovir", "Ganciclovir" and their analogues. According to indications, a surgical operation to remove the spleen can be performed.
Forecasts and Prevention
The increase in the childās lymph nodes in the peritoneum, detected at an early stage and correctly diagnosed, help to cope with the problem before dangerous complications occur. Unfortunately, in practice, enlarged lymph nodes are not immediately detected. Often the patient does not suspect that he has such an ailment. Pathology is detected by chance with any examinations of the digestive tract. Belated detection worsens forecasts.
Self-medication with the onset of symptoms of inflammation of the lymph nodes can result in the death of the child.
Prevention of mesadenitis and lymphadenopathy are such measures:
- Vaccinations (e.g., against flu, hepatitis).
- Timely detection and treatment of the underlying disease.
- Proper nutrition.
- Strengthen immunity.
- Hardening.
- Hygiene.
Such measures can reduce the risk of many infectious diseases, such as influenza, acute respiratory viral infections, helminth infections, which cause an increase in lymph nodes in the peritoneum.