Tuberculous mesenteric lymphadenitis

　　Tuberculous mesenteric lymphadenitis is caused by infection with Mycobacterium tuberculosis. The disease is more common in children and adolescents, and is primary or secondary. Primary cases often occur due to drinking milk or dairy products contaminated with Mycobacterium tuberculosis; secondary cases are more common than primary cases, and are often secondary to open pulmonary tuberculosis or intestinal tuberculosis. If the diseased lymph nodes rupture, it can cause tuberculous peritonitis.

　　Tuberculous mesenteric lymphadenitis has a good prognosis after active treatment. The caseous necrosis of the lymph nodes can gradually be absorbed, calcified, and self-healed. Chronic toxic symptoms may persist for a long time before disappearing. The caseous necrosis of the lymph nodes liquefies, ulcerates into the abdominal cavity or outside the abdominal wall to form a fistula that does not heal for a long time, and such cases are called mesenteric tuberculosis, which is now very rare.

　　Patients with tuberculous mesenteric lymphadenitis have persistent low fever and fatigue. There is often persistent dull pain around the umbilicus or in the lower right abdomen, which may occasionally worsen acutely, and can also manifest as acute abdominal pain, similar to colic, accompanied by nausea and vomiting, and may have diarrhea or constipation. Physical examination: Enlarged lymph nodes can be palpated around the umbilicus or in the upper left abdomen and lower right abdomen, with tenderness, often suspected to be acute appendicitis and surgery is performed.

　　Tuberculous mesenteric lymphadenitis is caused by infection with Mycobacterium tuberculosis. The key to preventing tuberculous mesenteric lymphadenitis is to actively prevent and treat pulmonary tuberculosis and intestinal tuberculosis, and at the same time, attention should be paid to dietary nutrition.

　　The diagnosis of tuberculous mesenteric lymphadenitis, in addition to symptoms and signs, also requires laboratory tests and auxiliary examinations. The main examination methods are as follows:
　　1. Erythrocyte sedimentation rate
　　It is significantly accelerated, which can be used as one of the indicators for evaluating the activity degree of tuberculosis.
　　2. Blood routine
　　White blood cell count is normal, lymphocytes are increased; hemoglobin is slightly decreased.
　　3. Tuberculin test
　　The tuberculin test at a concentration of 1:10,000 shows a positive reaction, which has reference value.
　　4. Abdominal flat film
　　There are scattered calcified shadows outside the mesentery, especially at the end of the ileum.
　　5. Barium meal examination
　　If there is concurrent intestinal tuberculosis, there may be increased intestinal motility, stimulation of the affected segment causing contraction, and poor filling. When the lesion involves the small intestine, barium meal may show irritation, increased small intestinal motility, and narrowing.
　　6. Chest X-ray
　　It can be found that there are pulmonary tuberculosis foci.
　　7. Smear and culture
　　Finding acid-fast bacilli in serous cavity fluid is an important means of diagnosing tuberculosis, but the positive rate is low, only 20% to 30%.

　　Patients with tuberculous mesenteric lymphadenitis should eat foods rich in protein and vitamins; they should eat foods that promote defecation. They should avoid eating greasy, fishy, and spicy foods; they should avoid eating gas-forming foods; they should avoid eating foods with long dietary fibers.

　　Patients with tuberculous mesenteric lymphadenitis should pay attention to nutrition, eat foods rich in protein, vitamins, and iron. Antituberculosis drug treatment, the method is basically the same as that of tuberculous peritonitis, the course of treatment is 1 to 1 and a half years. Enlarged lymph nodes compress abdominal organs and produce corresponding symptoms. When内科 treatment is ineffective, surgical treatment can be considered to relieve the compression. The other lymph nodes that do not produce compression symptoms are generally not treated.