Tips for using a medical presentation on mesenteric lymphadenitis
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This document provides tips for using a PowerPoint presentation on mesenteric lymphadenitis. It recommends: 1. Allowing free downloading, editing, and modification of the slides. 2. Noting that half the slides are blank except for the title to facilitate active learning sessions where students provide information to fill the blanks. 3. Showing blank slides, asking students what they know, and then showing the filled slides as a way to reinforce learning through multiple revisions.
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Tips for using a medical presentation on mesenteric lymphadenitis
- 1. Tips on using my ppt. 1. You can freely download, edit, modify and put your name etc. 2. Don’t be concerned about number of slides. Half the slides are blanks except for the title. 3. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. 4. At the end rerun the show – show blank> ask questions > show next slide. 5. This will be an ACTIVE LEARNING SESSION x three revisions. 6. Good for self study also. 7. See notes for bibliography.
- 3. Learning Objectives 1. Introduction & History 2. Relevant Anatomy, Physiology 3. Aetiology 4. Pathophysiology 5. Pathology 6. Classification 7. Clinical Features 8. Investigations 9. Management 10. Prevention 11. Guidelines 12. Take home messages
- 5. Introduction • Mesenteric lymphadenitis refers to inflammation of the mesenteric lymph nodes. This process may be acute or chronic, depending on the causative agent. It causes a clinical presentation that is often difficult to differentiate from acute appendicitis
- 6. Aetiology
- 7. Aetiology • Idiopathic • Congenital/ Genetic • Nutritional Deficiency/excess • Traumatic • Infections /Infestation • Autoimmune • Neoplastic (Benign/Malignant) • Degenerative / lifestyle • Iatrogenic • Psychosomatic • Poisoning/ Toxins/ Drug induced
- 8. Aetiology
- 9. Etiology Infections • beta-hemolytic streptococcus • Staphylococcusspecies • Escherichia coli • Streptococcus viridans • Yersinia species • Mycobacterium tuberculosis • Giardia lamblia, and non– Salmonella typhoid.
- 10. Etiology Infections :Virus • Viruses, such as coxsackieviruses (A and B), rubeola virus, and adenovirus serotypes 1, 2, 3, 5, and 7, have been implicated. • Epstein-Barr virus (EBV), acute human immunodeficiency virus (HIV) infection, and catscratch disease (CSD).
- 11. Pathophysiology
- 12. Pathophysiology • The frequent association of this condition, especially in children with upper respiratory tract infection, has popularized a theory that swallowed pathogen-laden sputum may be the primary source of infection. • Fecal-oral transmission occurs in Y enterocolitica infection and may present as a common source outbreak. This infection has also been associated with meat, milk, and water contamination. Rarely, person-to-person or zoonotic contacts with fecal carriers can lead to infection.
- 13. Pathophysiology • Microbial agents are thought to gain access to the lymph nodes via the intestinal lymphatics. • Grossly, the lymph nodes are enlarged and often soft. The adjourning mesentery may be edematous, with or without exudates • Microscopically, the lymph nodes show nonspecific hyperplasia and, in suppurative infection, necrosis with numerous pus cells.
- 15. Clinical Features • Demography • Symptoms • Signs • Prognosis • Complications
- 16. Clinical Features Demography • Up to 20% of patients undergoing appendectomy have been found to have nonspecific mesenteric adenitis. • The condition affects males and females equally. Yersinia infection is more common in boys than in girls. • ore common in children and adolescents younger than 15 years, and this condition during childhood or adolescence is linked to a significantly reduced risk of ulcerative
- 17. Clinical Features Symptoms • Abdominal pain - Often right lower quadrant (RLQ) but may be more diffuse • Fever, Malaise,Anorexia • Diarrhea • Concomitant or antecedent upper respiratory tract infection • Nausea and vomiting (which generally precedes abdominal pain, as compared to the sequence in appendicitis)
- 18. Clinical Features Signs • Fever (38-38.5°C) • Flushed appearance • RLQ tenderness - Mild, with or without rebound tenderness • Voluntary guarding rather than abdominal rigidity • Rectal tenderness • Rhinorrhea
- 19. Clinical Features Signs • Hyperemic pharynx • Toxic appearance • Associated peripheral lymphadenopathy (usually cervical) in 20% of cases
- 21. Diagnostic Studies Imaging Studies • X-Ray • USG • CT • Angiography • MRI • Endoscopy • Nuclear scan
- 22. Diagnostic Studies Laboratory Studies • CBC count: Leucocytosis • Serology can be supportive • Urinalysis • stool cultures • Blood culture:
- 23. Diagnostic Studies Imaging Studies • USG • CT • MRI • Laparoscopy
- 24. Diagnostic Studies Histopathology Lymph node specimen: In patients subjected to laparotomy, lymph nodes may show evidence of inflammation or suppuration, and culture may yield a causative organism.
- 26. Differential Diagnosis • Acute Pyelonephritis • Appendicitis • Benign Neoplasm of the Small Intestine • Cholecystitis • Chronic Mesenteric Ischemia • Cystitis in Females • Ectopic Pregnancy • Inflammatory Bowel Disease • Pelvic Inflammatory Disease • Urinary Tract Infection in Males
- 27. Management
- 28. Management • . Patients with mild, uncomplicated presentations do not require antibiotics, and supportive care generally suffices. • General supportive care includes hydration and pain medication after excluding acute surgical abdomen. • Empiric, broad-spectrum antibiotics
- 30. Operative Therapy • Surgery is usually indicated in suppuration and/or abscess, with signs of peritonitis, or if acute appendicitis cannot be excluded with certainty. • At laparotomy, the diagnosis is generally clear. An appendectomy should be performed in view of the tendency for recurrence of lymphadenitis and the difficulty in differentiating adenitis from appendicitis.
- 31. Get this ppt in mobile 1. Download Microsoft PowerPoint from play store. 2. Open Google assistant 3. Open Google lens. 4. Scan qr code from next slide.
- 32. Get this ppt in mobile
- 33. Get my ppt collection • https://www.slideshare.net/drpradeeppande/ edit_my_uploads • https://www.dropbox.com/sh/x600md3cvj8 5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl =0 • https://www.facebook.com/doctorpradeeppa nde/?ref=pages_you_manage
Editor's Notes
- drpradeeppande@gmail.com 7697305442