In children, the disease process most likely to be mis¬diagnosed as acute appendicitis is
|B||acute mesenteric lymphadenitis|
|C||acute regional enteritis|
Acute Mesenteric Adenitis
b. Almost invariably, an upper respiratory infection is present or has recently subsided.
c. The pain is usually diffuse, and tenderness is not as sharply localized as in appendicitis.
d. Voluntary guarding is sometimes present, but true rigidity is rare. Generalized lymphadenopathy may be noted.
e. Laboratory procedures are of little help in arriving at the correct diagnosis, although a relative lymphocytosis, when present, suggests mesenteric adenitis.
f. Observation for several hours is in order if the diagnosis of mesenteric adenitis seems likely, because mesenteric adenitis is a self-limited disease.
g. However, if the differentiation remains in doubt, immediate exploration is the safest course of action
b. The Meckel's diverticulum is located within the distal 2 feet of the ileum. Meckel's diverticulitis is associated with the same complications as appendicitis and requires the same treatment—prompt surgical intervention.
c. Resection of the segment of ileum bearing the diverticulum with end-to-end anastomosis can nearly always be done through a McBurney incision, extended if necessary, as well as laparoscopically.