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ABDOMINAL PAIN HELP MY 14 YEAR OLD!!!!
For 2 weeks now my 14 year old daughter has been having lower right abdominal pain, fever, dizziness, weakness, and nausea. We have been to the ER twice and our doctor three times. She has had a CBC (normal), 2 external ultrasounds (normal), 1 internal ultrasound (normal), CT scan (normal). Noone can figure out what is going on. She is frustrated and so am I. It is to the point that she doesn't want to go to the doctor or hospital anymore because she feels like they don't believe her. The pain is so bad that she can barely walk and is sometimes so severe that she is in the fetal position in tears. Any help or advice would be greatly appreciate....
Perhaps she needs another CT scan or MRI. She could have a condition where the intestines get twisted and cause a lot of pain. It could be serious.
I have pasted some information about mesenteric adenitis so that you can you can understand what this is.
Mesenteric lymphadenitis is an inflammation of the lymph nodes on the wall of the mesentery (the covering of the intestines).
If is often a childhood illness, though occasionally seen in adults.
It is a very common cause of abdominal pain in children, mimicking appendicitis, and often difficult to differentiate from appendicitis.
It is estimated that 1 in 5 children diagnosed with appendicitis actually have mesenteric lymphadenitis.
The causes of Mesenteric lymphadenitis usually follow viral infection with the common cold, or with infection by Yersinia enterocolitica, Pseudo tuberculosis, Streptococcus viridansor Campylobacter jejuni.
The bugs gain access to the wall of the intestine, and invade the lymph nodes on the covering of the intestines called the mesentery.
The small intestine is frequently more involved, but the large intestines or colon may also be involved.
The lymph nodes become enlarged due to inflammatory process induced by the micro-organisms.
The inflammatory process, coupled with the stretch effect on the wall of the mesentery by the enlarged lymph node cause pain.
In most cases the infection resolves on it own without the need to do anything.
The signs and symptoms of mesenteric lymphadenitis are very similar to those caused by appendicitis, but there can be some subtle differences in that the child is usually not as unwell as one with appendicitis.
The main signs and symptoms include :
•Abdominal Pain. This is often located in the right lower abdomen or right iliac fossa. It is a colicky abdominal pain which just resolves momentarily without any intervention. The sufferer, usually a child, may be completely pain free between attacks. Characteristically, the pain moves from one spot to the other on the abdomen, in keeping with the movement of the bowel loops in the abdominal cavity.
Asking the child to turn to the left side will demonstrate this shift as the area of pain and tenderness will move along with the bowel to the left.
In appendicitis, the pain may initially start around the umbilicus, then moves over to the right iliac fossa. Once it settles there, it does not move around any longer.
•Preceding Cold or Sore Throat. One thing in the history that gives away the diagnosis of mesenteric lymphadenitis is that of the presence of common cold or sore throat in the days or week before the onset of abdominal pain. There may even still be an on going cough and cold in the child. The neck glands, if examines may still be swollen.
•Fever. There may be an associated fever, running up to 38.5 degrees centigrade.
•Vomiting. Patient may vomit. If they vomited before the onset of pain, appendicitis is most unlikely.
•Diarrhoea. There may be episodes of loose stools, especially when there is infection. Appendicitis could also cause diarrhoea.
•Anorexia. Usually, with mesenteric lymphadenitis, patients are still able to eat and drink. If a patient complains of abdominal pain, and appetite remains good, it is most unlikely he or she has appendicitis.
.
Mesenteric lymphadenitis is often a benign illness, which usually resolves on it own without treatment.
Observing the child over night for a day may be needed in the hospital if parents are seriously worried.
Symptoms like fever may need administration of medications like paracetamol; vomiting if severe, may need oral rehydration or intravenous fluid administration.
Some times, mesenteric lymphadenitis infection may become severe, requiring the administration of antibiotics or even outright surgical operation to remove a section of diseased bowel plus the appendix.
There are other illness that can mimmick mesenteric lymphadenitis, so it is important to obseve the child, sometimes in hospital.
Even when she does not feel like eating, make sure she is drinking lots so she does not become dehydrated.
Hope she has a speedy recovery.
Mesenteric lymphadenitis is an inflammation of the lymph nodes on the wall of the mesentery (the covering of the intestines).
If is often a childhood illness, though occasionally seen in adults.
It is a very common cause of abdominal pain in children, mimicking appendicitis, and often difficult to differentiate from appendicitis.
It is estimated that 1 in 5 children diagnosed with appendicitis actually have mesenteric lymphadenitis.
The causes of Mesenteric lymphadenitis usually follow viral infection with the common cold, or with infection by Yersinia enterocolitica, Pseudo tuberculosis, Streptococcus viridansor Campylobacter jejuni.
The bugs gain access to the wall of the intestine, and invade the lymph nodes on the covering of the intestines called the mesentery.
The small intestine is frequently more involved, but the large intestines or colon may also be involved.
The lymph nodes become enlarged due to inflammatory process induced by the micro-organisms.
The inflammatory process, coupled with the stretch effect on the wall of the mesentery by the enlarged lymph node cause pain.
In most cases the infection resolves on it own without the need to do anything.
The signs and symptoms of mesenteric lymphadenitis are very similar to those caused by appendicitis, but there can be some subtle differences in that the child is usually not as unwell as one with appendicitis.
The main signs and symptoms include :
•Abdominal Pain. This is often located in the right lower abdomen or right iliac fossa. It is a colicky abdominal pain which just resolves momentarily without any intervention. The sufferer, usually a child, may be completely pain free between attacks. Characteristically, the pain moves from one spot to the other on the abdomen, in keeping with the movement of the bowel loops in the abdominal cavity.
Asking the child to turn to the left side will demonstrate this shift as the area of pain and tenderness will move along with the bowel to the left.
In appendicitis, the pain may initially start around the umbilicus, then moves over to the right iliac fossa. Once it settles there, it does not move around any longer.
•Preceding Cold or Sore Throat. One thing in the history that gives away the diagnosis of mesenteric lymphadenitis is that of the presence of common cold or sore throat in the days or week before the onset of abdominal pain. There may even still be an on going cough and cold in the child. The neck glands, if examines may still be swollen.
•Fever. There may be an associated fever, running up to 38.5 degrees centigrade.
•Vomiting. Patient may vomit. If they vomited before the onset of pain, appendicitis is most unlikely.
•Diarrhoea. There may be episodes of loose stools, especially when there is infection. Appendicitis could also cause diarrhoea.
•Anorexia. Usually, with mesenteric lymphadenitis, patients are still able to eat and drink. If a patient complains of abdominal pain, and appetite remains good, it is most unlikely he or she has appendicitis.
.
Mesenteric lymphadenitis is often a benign illness, which usually resolves on it own without treatment.
Observing the child over night for a day may be needed in the hospital if parents are seriously worried.
Symptoms like fever may need administration of medications like paracetamol; vomiting if severe, may need oral rehydration or intravenous fluid administration.
Some times, mesenteric lymphadenitis infection may become severe, requiring the administration of antibiotics or even outright surgical operation to remove a section of diseased bowel plus the appendix.
There are other illness that can mimmick mesenteric lymphadenitis, so it is important to obseve the child, sometimes in hospital.
Even when she does not feel like eating, make sure she is drinking lots so she does not become dehydrated.
Hope she has a speedy recovery.
With all the tests she has, I presume that appendix problems have been ruled out as well as inflamed glands.
Has she been checked for intestinal and bowel worms? My daughter was about 9 when she was having a similar problem and everyone thought she was putting it one because of school, but she loved going to school.
She was so ill that one night she was kept in hospital for observation. It was found that the mesenteric gland was swollen by a bacterial infection. She also passed a lot of very fat threadworms when she used the loo when in hospital. it was shocking.
Keep a food and drink diary to see if there is anything that makes her feel worse.
If this is a viral infection, keep her warm and give her plenty of drinks so that she does not become dehydrated.
If she gets a severe attack, take her back to the emergency room.
Hope you find the cause of your daughter's problem soon so that she can be treated accordingly.
Has she been checked for intestinal and bowel worms? My daughter was about 9 when she was having a similar problem and everyone thought she was putting it one because of school, but she loved going to school.
She was so ill that one night she was kept in hospital for observation. It was found that the mesenteric gland was swollen by a bacterial infection. She also passed a lot of very fat threadworms when she used the loo when in hospital. it was shocking.
Keep a food and drink diary to see if there is anything that makes her feel worse.
If this is a viral infection, keep her warm and give her plenty of drinks so that she does not become dehydrated.
If she gets a severe attack, take her back to the emergency room.
Hope you find the cause of your daughter's problem soon so that she can be treated accordingly.
Sorry she is having normal bowel movements and is not constipated. She said that sometimes it hurts in her butt also but the pain is constant.
She doesn't have periods she is on depo for the last 8 months. It happens all the time. She has a decreased appetite to the point that I have to force her to eat even just a little bit.
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