{ "schema_version": 1, "kind": "condition", "id": "mesenteric-adenitis", "name": "Mesenteric adenitis", "category": "acute", "sources": "Mesenteric Adenitis - StatPearls (NCBI Bookshelf NBK560822) - https://www.ncbi.nlm.nih.gov/books/NBK560822/ · Mesenteric adenitis - disease-level clinical article (mesenteric-adenitis-full.txt) · Mesenteric adenitis - disease-level clinical article (mesenteric-adenitis-clinical.txt) · MSF Essential Drugs 2024 (ibuprofen oral monograph)", "review_status": "reviewed", "verified_against": "Mesenteric Adenitis - StatPearls (NCBI Bookshelf NBK560822) - https://www.ncbi.nlm.nih.gov/books/NBK560822/ · Mesenteric adenitis - disease-level clinical article (mesenteric-adenitis-full.txt) · Mesenteric adenitis - disease-level clinical article (mesenteric-adenitis-clinical.txt) · MSF Essential Drugs 2024 (ibuprofen oral monograph)", "verified_date": "2026-08", "treatments": [ { "id": 1149, "generic": "Ibuprofen", "line": 1, "is_adjunct": false, "form": "oral.liquid", "strength_mg": 400.0, "adult_dose": "200 to 400 mg 3 to 4 times daily (maximum 1,200 mg daily)", "adult_duration": "A few days; the pain settles over days to weeks and does not need continuous treatment", "dose_source": "MSF Essential Drugs 2024 (ibuprofen oral monograph)", "rationale": "The cited article says mesenteric adenitis is self-limiting and needs no treatment once the surgical diagnoses have been excluded, and that management is supportive care with hydration and pain control using non-steroidal anti-inflammatory medicines. That is the whole of the drug treatment, and the dose is the standard one from the MSF monograph.", "cautions": [ "EXCLUDE APPENDICITIS FIRST. Giving an anti-inflammatory to a child whose real problem is a surgical abdomen buys hours that the child does not have.", "Give it with food. Avoid it in dehydration, in significant kidney disease, in active peptic ulceration and in asthma made worse by aspirin or another NSAID.", "TELL THE FAMILY IT TAKES TIME. The article stresses that improvement may come slowly over several weeks and that saying so prevents a lot of anxiety and repeat attendance - and it asks for planned review during that window rather than open-ended reassurance." ], "peds_mgkg_low": 5.0, "peds_mgkg_high": 10.0, "peds_max_mg": 400.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Child over 3 months: 5 to 10 mg/kg 3 to 4 times daily, maximum 30 mg/kg daily. Not for an infant under 3 months.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 50, "high_mg": 100, "capped": false }, { "weight_kg": 20, "low_mg": 100, "high_mg": 200, "capped": false }, { "weight_kg": 30, "low_mg": 150, "high_mg": 300, "capped": false }, { "weight_kg": 40, "low_mg": 200, "high_mg": 400, "capped": false } ], "brands": [ { "trade_name": "NOVA-PROFEN 100MG/5ML ORAL SUSP. 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 2.25, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 60 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUFEN 2% SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA", "price_egp": 4.5, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MARCOFEN 100MG/5ML SUSP. 120ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLAXO SMITHKLINE", "price_egp": 5.85, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PEOPOBRUF 50MG/1.25ML ORAL DROPS. 15 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "DELTA PHARMA > PEOPLE PHARMA", "price_egp": 9.0, "pack_count": null, "unit_price": null, "strength_mg": 50.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "IBUCALMIN 100MG/5ML SYRUP 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 28.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEGAFEN-N 100MG/5ML SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA", "price_egp": 35.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEN 100MG/5ML SYRUP 150ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > ABBOTT LABORATORIES", "price_egp": 44.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BRUFEMOL-N SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 4.75, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "IBUPROFEN 100MG/5ML SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "mesenteric-adenitis" }, { "id": 1150, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Mesenteric Adenitis - StatPearls (NCBI Bookshelf NBK560822) - https://www.ncbi.nlm.nih.gov/books/NBK560822/", "rationale": "Mesenteric adenitis matters because of what it is mistaken for. It needs no drug and no operation, but it can only be called after appendicitis has been excluded, so the safe use of the diagnosis is as a reason to image rather than a reason to reassure.", "cautions": [ "IT IS AN APPENDICITIS MIMIC, AND THAT IS THE WHOLE POINT - right lower quadrant pain of sudden onset looks so much like appendicitis that it has long been taken for it. In one series, 70 children were given a clinical diagnosis of acute appendicitis, and 16% of them turned out in the end to have mesenteric adenitis - established at operation, on imaging, or by how the illness ran.", "THE AGE AND THE STORY THAT POINT TOWARDS IT - below the age of ten, a child with sudden right lower quadrant pain is likelier to have mesenteric adenitis than appendicitis, and the adenitis often comes on the heels of a recent gastroenteritis or an upper respiratory infection.", "AND THE EXAMINATION DIFFERENCE, SUCH AS IT IS - surgeons often observe that pressing on the abdomen hurts markedly less in mesenteric adenitis than it does in acute appendicitis. Softer tenderness is a hint, never a discharge.", "BLOOD TESTS WILL NOT SETTLE IT - the white count and the CRP are usually raised, but normal values do NOT exclude the diagnosis. The article's own verdict on those same tests is that they are no help in separating appendicitis from intussusception or from mesenteric adenitis.", "ULTRASOUND IS WHAT SETTLES IT - ultrasound of the abdomen is the standard against which the diagnosis is made. What is diagnostic is mesenteric lymph nodes that are enlarged and hypoechoic, with no thickened blind-ending tube - an inflamed appendix - to be seen. For size, at least one node must be abnormally enlarged, 8 mm or more measured across its short axis.", "LARGE NODES ALONE DO NOT EXCLUDE AN APPENDIX - nodes enlarge in acute appendicitis too, and in a perforated one, which is part of why this is hard to call; but in appendicitis they tend to be fewer and less swollen.", "SEND THE URINE TOO - a urinalysis earns its place by excluding a urinary tract infection.", "NO DRUG TREATS IT - mesenteric adenitis settles by itself and calls for no treatment, so the first job in managing it is to exclude the diagnoses that need an operation. What is left is supportive: fluids intravenously, and pain relief with a non-steroidal anti-inflammatory. The article states no paediatric amount for any of them.", "WARN THE FAMILY IT IS SLOW, OR THEY WILL GO SOMEWHERE ELSE - it matters to tell them that getting better may take a while, coming on gradually across several weeks. The pain usually goes within four weeks and leaves nothing behind.", "BOOK THE FOLLOW-UP RATHER THAN LEAVING IT OPEN - it is reasonable to set clinic appointments through that period, to see how the child is progressing and to answer what worries the family.", "WHAT ELSE HIDES BEHIND THE SAME PAIN - the article's own differential runs to appendicitis, intussusception, a ruptured ovarian cyst, an ovarian abscess, ectopic pregnancy, endometriosis, torsion of an ovary or of a testis, epididymitis and pelvic inflammatory disease; and further down, the inflammatory bowel diseases - Crohn's and ulcerative colitis - along with malignancy, the zoonotic infections, infectious mononucleosis and tuberculosis.", "SOME OF IT IS BACTERIAL AND WORTH REMEMBERING IN EGYPT - two gram-negative organisms are well known to cause it: Yersinia pseudotuberculosis and Yersinia enterocolitica. Salmonella, E coli and the streptococci are named as further culprits.", "THE HARM OF GETTING IT WRONG RUNS BOTH WAYS - these children are frequently labelled appendicitis, and in the past that meant an appendix removed for nothing. Getting the diagnosis wrong exposes a patient to invasive procedures they did not need, and to whatever those procedures then cost them." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "mesenteric-adenitis" } ] }