5세 이하 소아 장간막 림프절염의 임상적 특성

Abstract

Purpose: Mesenteric lymphadenitis (ML) is a frequent cause of acute abdomen in children. Its clinical features in younger children can be different from those in older children, but there is no domestic study for that. So I did this study to know their clinical characteristics. Method: I collected the informations of ML patients under 18 years old who had been diagnosedand 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 ( 5 years old) and group B (>5 years old). Results: There were 17 cases for group A and 42 cases for group B. Group A were found commonly in spring (29.4%) and summer (29.4%). All of them were discharged within 7 days. Compared to patients in group B, the patients in group A showed more frequent respiratory features such as sputum (29.4% vs. 7.1%, P =0.037), less abdominal tenderness (47.1% vs. 76.2%, P =0.030), lower serum glucose level (85.8±22.1 mg/dL vs. 99.2.8±17.8 mg/dL, P =0.019), more ketonuria (70.6% vs. 36.8%, P =0.029), respectively. The admission duration and other features were not significantly different with each other, but group A had a tendency of more frequent hypertransaminasemia (18.8% vs. 9.5%) and higher CRP level (>4 times of upper normal limit, 31.3% vs. 20.5%) than group B. Conclusion: Younger patients have more extra-gastrointestinal features, less typical manifestations and severe laboratory findings than older patients in childhood ML, although their although their prognoses are comparable and fair. These findings should be kept in mind for physicians who care them and should be confirmed by further investigation.