Mesenteric Adenitis and Enteritis

Published on 19/07/2015 by admin

Filed under Radiology

Last modified 19/07/2015

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 Mesenteric adenopathy is often much more evident on coronal-reformatted CT

• Ileal ± cecal wall thickening, sometimes with regional ileus

image Mucosal hyperenhancement, submucosal edema
• Normal-appearing appendix


• Appendicitis
• Crohn disease

image Early Crohn disease may be impossible to distinguish
image Time course and likelihood of recurrence are different
• Cecal or appendiceal carcinoma

image Affects older adults, not children


• Reactive lymph node enlargement secondary to enteric pathogens
• Viral (most common)
• Bacterial (especially Yersinia and Campylobacter species)


• Commonly seen in children and young adults < 25 years old

image 8-12% of young patients with acute RLQ pain have mesenteric adenitis
• Pain, fever, nausea, vomiting

image Leukocytosis
• Self-limited, usually resolves without treatment
(Left) Axial CT in a 25-year-old woman presenting with fever and RLQ tenderness shows wall thickening and mucosal hyperenhancement of the terminal ileum and cecum image.

(Right) Another CT section in the same patient shows a normal appendix image, excluding appendicitis as the diagnosis.
(Left) Coronal-reformatted image in the same patient shows a cluster of mildly enlarged ileocolic mesenteric nodes image, along with the thick-walled, inflamed terminal ileum image.

(Right) Another coronal CECT section shows enlarged nodes and engorged vessels in the ileocolic mesentery image, along with the thick-walled terminal ileum. These are classic imaging and CT features of mesenteric adenitis and enteritis, and the patient made an uneventful recovery without specific therapy.



• Benign inflammation of lymph nodes in ileal mesentery, often with terminal ileitis


General Features

• Best diagnostic clue

image Cluster of slightly prominent (≥ 5 mm) mesenteric lymph nodes in right lower quadrant (RLQ)

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