5.Palpation of the abdomen reveals moderate tenderness to the left of the navel (positive Sternberg's symptom), positive Kline's symptom (displacement of tenderness when the patient moves to the left side). Symptoms of peritoneal irritation were not expressed. Enlarged caseous lymph nodes, which would be accessible to palpation, especially in adults are observed as an exception.

6.Chronic tuberculous mesadenitis has a fluctuating course, with periods of exacerbations followed by remissions. The most frequent symptom is abdominal pain, which corresponds to the localization of the pathological process (projection of the mesenteric root). The pains can be dull, aching, or colicky. Patients often complain of bloating of the abdomen, which increases by the end of the day. Pain is often caused by pressure of calcified lymph nodes on the neurovascular bundle of mesentery. Bedsores may form.

Diagnostics:

1.Ultrasound of lymph nodes.

2.Сomputed tomography

3.Radiological examination of the affected

lymph nodes (areas of calcification can be detected).

4.Reaction to intradermal tuberculin injection is moderate or severe. Subcutaneous tuberculin injection is often associated with general or focal reactions (blood count shifts, increase in body temperature, appearance or increase in abdominal pain).

Diagnostics:

5.Detection of Mycobacterium tuberculosis in fistula discharge.

6.Puncture or excisional biopsy of the lymph node followed by morphological and bacteriological examination of the biopsy specimen.

7.Laparoscopy is indicated in diagnostically unclear cases of mesenteric lymph node involvement.

8.Trial treatment.

TREATMENT OF TUBERCULOSIS

OF LYMPH NODES:

1.GENERAL PRINCIPLES OF TUBERCULOSIS TREATMENT.

2.PUNCTION.

3.SURGICAL TREATMENT (REMOVAL).

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