Prevalence, factors associated, and histological pattern of incidental enlarged mesenteric lymph nodes among patients undergoing laparotomy at referral hospitals in central Tanzania; a cross-sectional study.

BACKGROUND

There are different causes of Incidental Enlarged MesentericLlymph Nodes (IMLN) found during laparotomy, which most of the time influence the postoperative course. These causes are variable across the globe, but the node pattern in our locality and the factors associated with the incidental enlarged mesenteric lymph nodes are not yet established. Due to the lack of an established protocol in our locality, there have been some mismanaged cases that led to several postoperative complications. Therefore, this study aimed to evaluate the prevalence, factors associated with, and histological pattern of incidental mesenteric lymphadenopathy.

METHODOLOGY

The 885 patients were conveniently recruited in the study. The incidental enlarged mesenteric lymph nodes were taken during surgery, processed and histologically analyzed as per pathological protocol. Obtained data were filled out and analyzed using SPSS version 27. Binary logistic regression was used to examine clinical data, with a significance level of p < 0.05, to determine the factors linked to lymph node enlargement.

RESULTS

It was seen that 58.08% of the study group, with a mean age of 30.5 years, were between the ages of 21 and 40. Males accounted for 71.53% of the total, while 252 individuals were female, giving a M: F ratio of 2.5:1. The prevalence of incidental mesenteric lymphadenopathy was 12.5%. Associated factors of Incidental Mesenteric Lymphadenopathy in this study were HIV, smoking, nomadic pastoralism, and surgical indication. HIV-positive patients were 7 times more likely to have IML with a 95% CI [2.975, 16.741], and (p < .0001), smokers were 10 times more likely to have IMLN, 95% CI [3.745, 28.458], and (p < .0001), nomadic pastoralists were 3 times more likely to have IMLN, 95% CI [1.647, 5.882], and (p < .0001) and patients who were operated upon peritonitis were 3 times more likely to have IMLN, 95% CI [2.040, 7.572], and (p < .0001). Of the incidental lymphadenopathy (N = 111), 23.42% had granulomatous tuberculous lesions, and 9.01% of lymph nodes harbored malignancy. About 47% of patients had histologically confirmed reactive lymph nodes, while 20.72% had an inflammatory pattern. CONCLUSION AND RECOMMENDATION: The major factors associated with incidental enlarged mesenteric lymph nodes are smoking, comorbidities such as HIV and diabetes, malignancies, and infections such as tuberculosis. The common histological pattern is reactive nodes though there are potentially fatal nodes that were discovered including those that harbored malignancies and infections such as Tuberculosis. Therefore, to rule out potentially fatal illnesses and comorbidities that can be treated early to spare patients from extended hospital stays and potentially disastrous results, comprehensive investigations should be conducted in the event of incidentally enlarged mesenteric lymph nodes are found during a laparotomy.