Multiple mesenteric lymphadenopathies in pediatric with ulcerative colitis: A case report

Ulcerative colitis (UC) is one of the two major disorders in pediatric inflammatory bowel disease (IBD). Differentiating IBD at an early stage remains difficult, and abdominal imaging and early precise investigations are crucial. A 2-year-old girl was referred to the emergency department after experiencing colicky abdominal pain for one month. She had bloody stool four days before admission with the frequency about 1-2 times per day. She also experienced anorexia, nausea, and weight loss. From Abdominal CT-Scan with contrast, multiple mesenteric lymphadenopathies accompanied by liver enlargement and minimal ascites were found. Colonoscopy showed multiple ulcers in rectum and sigmoid colon. The histology of the gastric and colon showed lymphocytes infiltration in lamina propria. Children with UC usually present with the classic symptoms of weight loss, abdominal pain, and bloody diarrhea. The UC patients could present also with non-classic symptoms of poor growth, anemia, or extraintestinal manifestations. The presence of inflamed mesenteric lymph nodes in the inflammatory process in UC can be associated with peri-intestinal inflammatory reactions. Mesenteric lymphadenopathies can happen in UC and early investigations using colonoscopy and biopsy is the important investigative procedure to evaluate patient with UC.