단일 지역사회 병원에서 관찰된 소아 장간막 림프절염의 최근 역학 및 임상 양상

Abstract

Purpose: Mesenteric lymphadenitis is one of common causes of childhood acute abdomen and notorious for the clinical resemblance to acute appendicitis. It was frequently found in spring and boy during last decade, but that was not observed recently. So I did this study to know its recent epidemical and clinical features. Method: I collected the informations of mesenteric lymphadenitis patients under 18 years old who had admitted and diagnosed at Yogin Severance Hospital from January 2012 to December 2017. The diagnosis was made with abdominal ultrasound or CT scan. They were investigated with retrospective method. Results: There were 53 cases for 6 years. Their mean age and male to female ratio were 7.5±3.6 years old and 27:26. There was a surge of the cases in 2017 (16 cases, 30.2%). All cases except one were acute. The most common season was autumn (32.1%). Abdominal pain (94.3%), fever (75.5%), vomiting (56.6%), diarrhea (47.2%) were found commonly in order. Abdominal tenderness was found in about two-thirds of them (67.9%). Regarding to abnormal laboratory findings, leukocytosis (47.2%), increased ESR (46.7%) and C-reactive protein (56.3%), decreased serum total CO2 content (86.5%), ketonuria (50.9%) were observed. Almost all of them (96.2%) were discharged within 7 days. When comparing the cases in 2017 (group A) with the cases from 2012 to 2016 (group B), summer was the most common season for group A (50.0% for group A vs. 10.8% for group B, P <0.001). Group A showed higher frequency of hyponatremia (50.0% vs. 16.2%, P =0.010), lower serum potassium level (3.9±0.4 mM/L vs. 4.1±0.4 mM/L, P =0.040), higher glucose level (108.1±22.2 mg/dL vs. 88.1±16.7 mg/dL, P <0.001), lower ESR (9.0±6.6 mm/hr vs. 17.2±12.4 mm/hr, P =0.022) than group B.Conclusion: The epidemiological and clinical features in childhood mesenteric lymphadenitis are changed. Its general prognosis is not bad but the clinical manifestation seems to become worse recently.