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Saturday, August 29, 2009

Right lower Abdominal Pain In Young -6

Posted by Dr Prahallad Panda on 7:36 PM Comments

Schematic figure of the bursa omentalis, etc. ...Image via Wikipedia
Young adolescent boys and girls sometimes get pain in the right lower abdomen that may confuse with an acute appendicitis.Though there are several causes mesenteric adenitis is of particular interest.There is pain,vomiting  and sometimes fever.On examination of abdomen the site of pain can not be accurately located.Patient sometimes indicate a particular point of pain only to show a fresh point at some other time.The location of pain changes with the change of position of patient.That is the catch point.
  Mesentery is the attachment to the gut that holds it suspended inside the abdomen.There  are lymph nodes within it which collect nutrients from gut after digestion of food.Sometimes they get infected and become a source of pain.As mesentery is a long structure and hangs with certain degree of mobility the location of pain keeps on changing with the position the patient adopts.
  This can be differentiated from appendicitis with it's characteristic pain pattern and an ultrasound may demonstrate a healthy appendix.Sometimes it is hard to differentiate it from appendicitis in spite of all available investigations. In case of doubt a laparoscopy will be able to differentiate it from appendicitis.If still in doubt an appendicectomy is done which many times cures it.It just like two in one treatment.If correctly diagnosed a simple conservative approach by the way of parenteral feeding ,antibiotics  and analgesics will cure the condition .    
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