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Mesenteric lymphadenitis AFTER appendectomy
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Mesenteric lymphadenitis AFTER appendectomy

My 10-year-old son, who has always been a healthy boy except for a case of pneumonia when he was 6, had an appendectomy just about a month ago. After the surgery, the surgeon said it was an unusual case -- his appendix was severely scarred, difficult to find, and so enlarged it was difficult to remove. Because of this, his surgery took about 1 hr longer than expected but his initial recovery was relatively easy and after a week of resting, he went back to school.

Then, last week while we were vacationing at Disney, he developed a 103 fever, had a sore throat, and stomach pain. I took him to an urgent care clinic and the dr couldn't find anything wrong after diagnosis but since we were on an expensive vacation, he offered antibiotics just in case. After less than a day on the antibiotics, he felt better and (I know this is a "no no") I stopped giving him the antibiotics.

Well, 2 days ago, less than a week since his last fever, he got a fever of 102 and more severe pain in his right side. We took him to his primary care doctor who did blood work and a CAT scan because she was afraid there may have been internal infection. After the scan and consulting with the surgeon, the dr reported to me that he has mesenteric lymphadenitis and said this is a common issue after an appendectomy and requires no treatment other than lots of fluids and rest. I took the dr's word for it and left the office relieved he didn't need another surgery.

But, of course, when I got home I googled it and I can't find any info about patients getting mesenteric lymphadenitis after an appendectomy. From what I read, it can often be confused with appendicitis but not related to it. So, now I'm worried there's something else going on. If the surgeon hadn't said that his appendix was very scarred, I would wonder if the appendectomy was done in error because they may have confused mesenteric lymphadenitis with appendicitis. But, that doesn't seem to be the case. So, instead I'm more worried that this diagnosis is wrong and that there may be something else going on.

I want to get a second opinion at Children's Hospital in Boston but they don't schedule weekend appts and I don't know if this is ER worthy. So, I'm wondering if anyone has any insight, advice, or similar experiences.

We're keeping his fever and pain under control with tylenol, and he's acting like his usual happy self. I just love him so much that I hope there's nothing seriously wrong. My anxiety has been out of control worrying about him!

Thanks so much to anyone who takes the time to read this.
Tags: Mesenteric lymphadenitis, appendectomy, scarred appendix, child
Avatar_dr_f_tn
Hello and understand your anxiety. The mesenteric lymph nodes could be a consequence to the chronic appendicitis he had. Chronic appendicitis was evident from your doctors description. Lymph nodes enlarge in response to an infection. And lymphadenitis is treated with antibiotics and anti inflammatories. So, give him the antibiotics and complete the course. As long his symptoms are responding well to the medications and he is improving you don't have to worry. If they persist or worsen then you can consider getting a second opinion. Regards.
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