Mesenteric adenitis-acute ileitis: A constellation of findings definable with ultrasound

We present the ultrasonographic findings in 45 pediatric patients referred to us for acute abdominal pain mimicking appendicitis. All of the patients demonstrated right lower quadrant or paraaortic tender adenopathy consistent with the diagnosis of mesenteric adenitis, but in addition, many of the patients demonstrated other findings, including intestinal hyperperistalsis, small bowel (jejunal and ileal) mucosal thickening (both circumferential and nodular), mesenteric thickening around the nodes, fluid- filled loops of intestine, a visible appendix which was often fluid filled, free fluid, a right lower quadrant mass, and cecal involvement. These diverse findings suggest that mesenteric adenitis need not be limited to adenopathy and ileocolitis in the right lower quadrant. These additional findings are helpful in differentiating mesenteric adenitis from appendicitis, even in those patients in whom a fluid-filled appendix is visualized.