Significance of Mesenteric Lymphadenopathy in Children with Recurrent Abdominal Pain Reported at Federal Government Polyclinic Hospital, Islamabad

Abstract

Background: There is growing evidence linking recurrent abdominal pain (RAP) in children to mesenteric lymphadenopathy (MLA), which is often a benign and incidental finding. Evaluating MLA in broader clinical context is crucial to prevent unnecessary invasive procedures.

Objective: To assess the frequency of MLA in children aged 5-12 years with RAP compared to age-gender matched controls and to assess the association between MLA and symptoms.

Methods: Children aged 5-12 years who experienced RAP were included in this prospective case-control study, which was carried out at the outpatient of Paediatric Department of the Federal Government Polyclinic Hospital, Islamabad from June 2022 to December 2023. The controls were age and gender matched children without minor abdominal complaints, children with abdominal pain due to other causes were carefully excluded. MLA was diagnosed when lymph nodes size was ≥ 5 mm on abdominal ultrasound. Using SPSS V.23, odds ratios (OR) were calculated with statistical significance set at p <0.05.

Results: There were 300 children in the study (150 cases and 150 controls), all of whom had comparable ages and genders (p >0.05). Compared to controls, MLA was more prevalent in cases (30% vs. 8.7%, p =0.001) and mean lymph nodes size was significantly larger on both short and long axis (p < 0.05). For nodes larger than ≥ 5 mm, the OR was 4.5. MLA was not significantly associated with severity of symptoms (p >0.05).

Conclusion: Children with RAP had a much higher prevalence of MLA than matched controls. However, no significant association ............