The mesentery is filled with lymphatic vessels and lymph nodes, with mesenteric lymph nodes mostly located around the mesenteric arterial pulse. Subcutaneous nodular bacillus infection can cause mesenteric lymph node subcutaneous nodules. This disease is more common in children and adolescents and is divided into primary and secondary types. Primary cases often occur due to drinking milk or dairy products contaminated with subcutaneous nodular bacilli; secondary cases are more common than primary ones and usually follow open pulmonary subcutaneous nodules or intestinal tuberculosis. If the affected lymph nodes rupture, they can cause subcutaneous nodular peritonitis.

bubble_chart Diagnosis

1. History Taking

Mild cases may be asymptomatic, while more severe cases may present with general symptoms of subcutaneous nodes such as afternoon low-grade fever, night sweating, and lack of strength, as well as digestive symptoms including abdominal pain, diarrhea, abdominal distension and fullness.

2. Physical Examination Findings

During abdominal palpation, enlarged lymph nodes measuring 2–3 cm in diameter may be detected in the right lower abdomen or mid-abdomen. Sometimes multiple nodes are present, immobile with irregular margins and tenderness.

3. Laboratory Tests

Abdominal X-ray plain films may reveal several round or oval spots or patchy calcifications with uneven density at the root of the mesentery. On lateral films, these shadows appear anterior to the spine. Ultrasound and CT scans help identify non-calcified enlarged lymph nodes. For clinically challenging diagnoses, a trial of anti-subcutaneous node therapy may be administered. Some cases are incidentally discovered during appendectomy.

Treatment of subcutaneous nodules (same as subcutaneous nodular peritonitis).