NDLI: Prevalence, factors associated, and histological pattern of incidental enlarged mesenteric lymph nodes among patients undergoing laparotomy at referral hospitals in central Tanzania; a cross-sectional study

Content Provider	Springer Nature : BioMed Central
Author	Rweyemamu, Devotha Josephat Mwashambwa, Masumbuko Yatembela
Abstract	Background There are different causes of Incidental Enlarged MesentericLlymph Nodes (IMLN) found during laparotomy, which most of the time influence the postoperative course. These causes are variable across the globe, but the node pattern in our locality and the factors associated with the incidental enlarged mesenteric lymph nodes are not yet established. Due to the lack of an established protocol in our locality, there have been some mismanaged cases that led to several postoperative complications. Therefore, this study aimed to evaluate the prevalence, factors associated with, and histological pattern of incidental mesenteric lymphadenopathy. Methodology The 885 patients were conveniently recruited in the study. The incidental enlarged mesenteric lymph nodes were taken during surgery, processed and histologically analyzed as per pathological protocol. Obtained data were filled out and analyzed using SPSS version 27. Binary logistic regression was used to examine clinical data, with a significance level of p < 0.05, to determine the factors linked to lymph node enlargement. Results It was seen that 58.08% of the study group, with a mean age of 30.5 years, were between the ages of 21 and 40. Males accounted for 71.53% of the total, while 252 individuals were female, giving a M: F ratio of 2.5:1. The prevalence of incidental mesenteric lymphadenopathy was 12.5%. Associated factors of Incidental Mesenteric Lymphadenopathy in this study were HIV, smoking, nomadic pastoralism, and surgical indication. HIV-positive patients were 7 times more likely to have IML with a 95% CI [2.975, 16.741], and (p < .0001), smokers were 10 times more likely to have IMLN, 95% CI [3.745, 28.458], and (p < .0001), nomadic pastoralists were 3 times more likely to have IMLN, 95% CI [1.647, 5.882], and (p < .0001) and patients who were operated upon peritonitis were 3 times more likely to have IMLN, 95% CI [2.040, 7.572], and (p < .0001). Of the incidental lymphadenopathy (N = 111), 23.42% had granulomatous tuberculous lesions, and 9.01% of lymph nodes harbored malignancy. About 47% of patients had histologically confirmed reactive lymph nodes, while 20.72% had an inflammatory pattern. Conclusion and recommendation The major factors associated with incidental enlarged mesenteric lymph nodes are smoking, comorbidities such as HIV and diabetes, malignancies, and infections such as tuberculosis. The common histological pattern is reactive nodes though there are potentially fatal nodes that were discovered including those that harbored malignancies and infections such as Tuberculosis. Therefore, to rule out potentially fatal illnesses and comorbidities that can be treated early to spare patients from extended hospital stays and potentially disastrous results, comprehensive investigations should be conducted in the event of incidentally enlarged mesenteric lymph nodes are found during a laparotomy.
Related Links	https://bmcsurg.biomedcentral.com/counter/pdf/10.1186/s12893-024-02745-0.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14712482
DOI	10.1186/s12893-024-02745-0
Journal	BMC Surgery
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-02-11
Access Restriction	Open
Subject Keyword	Surgery Internal Medicine Incidental mesenteric lymph node enlargement Histological pattern Peritoneal Tuberculosis
Content Type	Text
Resource Type	Article
Subject	Surgery
Journal Impact Factor	1.6/2023
5-Year Journal Impact Factor	1.9/2023

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