Shahba Ladan, Kuhestani Parizi Maryam, Shafie Mohammad
Surgery Department, Kerman Medical University, Kerman, IRN.
Cureus. 2024 Jun 15;16(6):e62437. doi: 10.7759/cureus.62437. eCollection 2024 Jun.
Acute appendicitis is a major cause of emergency surgery in children and adolescents. Mesenteric lymphadenitis is also one of the most common differential diagnoses in children with acute appendicitis, and despite its high prevalence, few clinical studies have examined its features. The clinical signs of mesenteric lymphadenitis in children are very similar to those of acute appendicitis. The aim of this study was to determine the clinical manifestations of acute appendicitis and mesenteric lymphadenitis in children.
In this cross-sectional study, patients less than 15 years old admitted to the pediatric emergency center of Afzalipour Hospital in Kerman from 2018 to 2021 were studied, and those who had a final diagnosis of appendicitis, mesenteric lymphadenitis, or appendectomy were included in the study by census. Data collection from the records of these patients included age, sex, clinical signs, duration of emergency until diagnosis, fever, number of times of vomiting, leukocytosis, lymphocyte, neutrophil count, neutrophil-to-lymphocyte ratio, sonographic findings, and pathology findings. SPSS software and descriptive and analytical statistics were used to analyze the data.
The results showed that unlike sex (p=0.11), there was a significant difference between the two groups in terms of age (p<0.001). Nausea, vomiting, anorexia, pain shift, and leukocytosis were more common in the acute appendicitis group than in the mesenteric lymphadenitis group, with a significant difference between the two groups (p<0.001). There was a significant difference between the two groups in terms of neutrophil percentage and neutrophil-to-lymphocyte ratio (p<0.001).
The present study was conducted with the aim of assisting medical professionals due to the possibility of misdiagnosing mesenteric lymphadenitis with acute appendicitis. Differentiation of these two diseases is facilitated by the significant differences in their clinical signs and test results. These results can be a useful guide for physicians to better diagnose the diseases.
急性阑尾炎是儿童和青少年急诊手术的主要原因。肠系膜淋巴结炎也是急性阑尾炎患儿最常见的鉴别诊断之一，尽管其发病率很高，但很少有临床研究对其特征进行研究。儿童肠系膜淋巴结炎的临床症状与急性阑尾炎非常相似。本研究的目的是确定儿童急性阑尾炎和肠系膜淋巴结炎的临床表现。
在这项横断面研究中，对2018年至2021年在克尔曼省阿夫扎利普尔医院儿科急诊中心就诊的15岁以下患者进行了研究，通过普查将最终诊断为阑尾炎、肠系膜淋巴结炎或阑尾切除术的患者纳入研究。从这些患者的记录中收集的数据包括年龄、性别、临床症状、从急诊到诊断的持续时间、发热、呕吐次数、白细胞增多、淋巴细胞、中性粒细胞计数、中性粒细胞与淋巴细胞比值、超声检查结果和病理检查结果。使用SPSS软件以及描述性和分析性统计方法对数据进行分析。
结果显示，与性别（p=0.11）不同，两组在年龄方面存在显著差异（p<0.001）。恶心、呕吐、厌食、疼痛转移和白细胞增多在急性阑尾炎组比肠系膜淋巴结炎组更常见，两组之间存在显著差异（p<0.001）。两组在中性粒细胞百分比和中性粒细胞与淋巴细胞比值方面存在显著差异（p<0.001）。
由于肠系膜淋巴结炎可能被误诊为急性阑尾炎，本研究旨在为医学专业人员提供帮助。这两种疾病在临床症状和检查结果上的显著差异有助于对它们进行鉴别。这些结果可为医生更好地诊断疾病提供有用的指导。
