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Child Having Stomach Ache. Enlarged Mesenteric Lymph Nodes In CT Scan. History Of Staph Infections. Are They Related?

Posted on Tue, 12 Jun 2012

Question: my son had a ct scan done the day before yesterday and we were told his mesentery lymph nodes were enlarged. The reason why we took the ct was because of a painful stomach ache for over a week. Actually he's been complaining of a stomach pain for a few months with nausea and vomiting. He's had 6 staph infections on various parts of his body as well over the past year. Are these related. Should I be concerned? He now barely eats. Lost a few pounds. I'm having trouble getting my pediatrician on the phone and the nurses won't give me any information. He's always been very tired. Has a lot of headaches, been to the pediatric nuerosurgeon and was cleared. Been to an infectious disease doctor and has been given various antibiotics to stop staph. Staph has been under control for about 2 months. Had an ultra sound of his appendix last week and the appendix appeared fine.

Answered by Dr. Taher Y Kagalwala (11 hours later)

Dear XXXXXXX

Thank you for posting for your query.

I think your son will need further evaluation as he has an abnormal CT. First of all, we have to try and determine why the glands in his mesentery (this is a membranous tissue that binds the loops of intestine and other abdominal structures to each other) are enlarged. The first thing that comes to mind is whether he has intestinal inflammation - either due to his allergic predisposition or due to some infection. If he has no fever and no localisation of his pain (for example, the pain from stomach illnesses is typically in the centre of the upper part of the abdomen, that from the appendix is from the right lower quadrant, and so on), then you should take him for urine, blood and stool tests to find out why he has pain.

Does he have any urinary pain? Has he suffered recently from loose stools? Does he have right upper quadrant pain (typically caused by inflammation of the liver)?

Viral illnesses of some types can linger in the body for weeks - for example, Infectious Mononucleosis - a virus that also causes throat inflammation, neck lymph glands, and tiredness and fever. The nausea and vomiting could point to either stomach or the liver or gall bladder being the causes of his stomach ache. So also the reduced appetite and the loss of weight.

Please find a Pediatrician soon and take him for the tests that I have just mentioned. The blood tests he will need are liver function tests, the mono-spot test, a complete blood count and tests to rule out gut infections. You need to provide me with details of your city and whether the child recently travelled to a tropical country/region within your country. By recent, I mean pre-dating his stomach complaints.

Please revert to me when you get those tests done and for further information on your son's illness.

I hope and pray that he gets well soon.

Regards.

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Taher Y Kagalwala (37 minutes later)

I got a copy of the ct scan and the organs all look good. the only thing on it was "multiple midly prominent lymph nodes in the root of the mesentery the largest being 1.4x1.2. The radiologist possible diagnosis was mesenteric adenitis. The thing that confuses me is that with all of his infections, he never has had a fever. Not with the staph and not with this. Is that normal? Another thing I would like to mention is when he was born he had meconium and had to have his lungs suctioned. He was a very colicy baby. And he is always not feeling good. Mostly fatigued. Lately he says he's hungry, when I give him something to eat he eats a little and says he can't eat anymore. He doesn't even snack anymore which is odd for him. I took him to the gastro doctor and she is running blood tests and stool tests. Anything I should ask her about?

Answered by Dr. Taher Y Kagalwala (2 hours later)

Hello again Mrs XXXXXXX

Thank you for writing back.

I am glad that the report is only what you say and that all the organs are normal.

I think the blood and stool tests may help in finalising the diagnosis, though it appears to be just viral. The reduced appetite is expected since the child does have pain.

I don't think his neonatal history has any significant bearing on the current illness.

Please revert to me after the gastro doctor has seen him and the tests results are in.

Take care.

With warm regards,

Dr. Taher

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Above answer was peer-reviewed by : Dr. Yogesh D