소아 급성 장간막 림프절염에 있어서 비특이성 및 특이성 환자에서 나타난 최근 임상양상의 비교

Abstract

Purpose: Acute nonspecific mesenteric lymphadenitis is one of common causes of childhood acute abdomen.The differences between the nonspecific and specific type were told to be the presence of combined disorder(s) as well as clinical manifestations and laboratory findings. But those were not conclusive and no consecutive domestic study had done, so I did this study to know its update clinical features. Method: I collected the informations of acute mesenteric lymphadenitis patients under 18 years old who had been diagnosed and admitted at Yogin Severance Hospital from January 2012 to August 2018. The diagnosis was made with abdominal ultrasound or computer tomography. They were divided into group A (nonspecific mesenteric lymphadenitis) and group B (specific mesenteric lymphadenitis). Results: There were 36 cases for group A and 22 cases for group B. The mean age and male to female ratio for group A were 7.7±4.1 years old and 1:1, respectively. The symptoms of group A were abdominal pain (94.4%), fever (63.9%), vomiting (61.1%), diarrhea (52.8%) in common order and abdominal tenderness was found in more than three quaters of them (77.8%). Regarding to abnormal laboratory findings of group A, decreased serum total CO2 content (88.2%), increased ESR (46.7%) and Creactive protein (48.5%), ketonuria (48.6%), leukocytosis (22.2%) were observed. were discharged within 7 days. When compared to group B, group A showed a tendency of shorter admission duration,lower frequency of fever,more frequent diarrhea and abdominal tenderness , but there was no significant statistical difference between them. Group A had significantly more mean WBC count, absolute neutrophil count,and absolute lymphocyte count than group B. Conclusion:There is no significant clinical and epidemiological difference between the two groups except presence of combined disorder(s) and the prognosis is fair for both of them. That should be confirmed by further investigation.