Evaluation of mesenteric lymph nodes in pediatric patients who underwent abdominal CT for trauma and comparison of findings with patients with acut abdomen

Routine evaluation of mesenteric lymph nodes in children in daily clinical practice is usually performed by using abdominal USG.CT imaging is a rare method to use especially on pediatric patients because of its radiation side affects.Abdominal CT is preferred when abdominal USG is inadequate in the diagnosis of pediatric patients.Mesenteric lymph nodes are generally detected by abdominal CT as an incidence and normal lymph nodes and mesenteric lymphadenopathy can be seen on CT scans.The aim of this study is to determine the number,size and location of the lymph nodes detected in the mesenteric area on CT scans of pediatric patients admitted to the emergency with trauma. MATERIAL AND METHOD In our study all the patients admitted to the emergency department of Dicle University Medical Faculty Hospital between March 2012 and August 2019 with trauma and acute abdominal pain is evaluated retrospectively using with and without contrast according to number,size,location and age distribution of the patients.Total of 280 patients with 200 trauma and 80 acutte abdomen is included in the study.The cases consist of 184 male and 96 female patients.In the control group trauma patients who had following diagnosis is presented with acute abdomen,acute appendicitis,acute enterocolitis,ovarian torsion,ovarian cyst,ileus,acute cholecystitis,invagination,epiploic appendigitis,duodenum perforation,acute pancreatitis,ureteral stone,pyelonephritis,mesenteric torsion.Patients with diagnosed lymphproliferative disease is not included in the study because they may lead to misinterpretation of the results. FINDINGS According to our findings,although the mean number of mesenteric total lymph nodes are higher in the case group (22.15 in the case group and 19.35 in the control group),no statistically significant difference is found between them.The mean number of lymph nodes with a diameter less than 5 mm is found to be higher in the control group and in the case group with shorter lymph nodes greater than 5-9 mm and 10 mm.In addition, largest short diamater,largest long diamater, and arithmetic mean of short diamater values are significantly higher in the case group.There is no significant difference between the groups in arithmetic of long diamater.In the case group,no significant difference is found between the total number of lymph nodes between age groups and the total number of lymph node is found to be 68.8% in the case group and 82.5% in the patient group with mesenteric root location,followed by the right lower quadrant with 31.3% and 14%,respectively.In the case group,the proportion of the right lower quadrant within the total lymph nodes is found significantly higher than in the caontrol group.In both groups,lymph nodes with largest short diamater and largest long diamater values is located in the right lower quadrant.It was observed that the rounding index increased in the case group compared to the control group. RESULT As a result, the area, size and shape of the mesenteric lymph nodes can give us clues about the intra-abdominal inflammatory status and can be used to distinguish normal lymph nodes from pathological ones. Keywords Children, trauma, acute abdomen, mesenteric lymph nodes, computed tomography