Retroperitoneal lymphadenopathy, most commonly caused by inflammation

The most common cause of retroperitoneal lymphadenitis is retroperitoneal lymphadenitis, which can be acute or chronic. Acute patients will have symptoms of high fever and chills, while chronic patients will have symptoms of low fever, abdominal distension, nausea and vomiting.

1. Acute retroperitoneal lymphadenitis

The main symptoms are high fever and chills, accompanied by abdominal pain and bloating, pain in the lower back, nausea, vomiting, etc. The body temperature can reach 39-40℃, presenting as remittent fever or retained fever. Examination shows abdominal tenderness and rebound pain, but no obvious muscle tension. In severe cases, there may be signs of intestinal paralysis, percussion pain in the lower back and back, and an increase in white blood cell count.

2. Chronic or tuberculous retroperitoneal lymphadenitis

Tuberculosis can invade the retroperitoneal lymph nodes. It can be one of the local components of the primary syndrome or a result of widespread dissemination of tuberculosis. The affected lymph nodes can be treated without symptoms and eventually calcify. Some lymph nodes are swollen, undergo dry necrosis, and even form abscesses. The onset of this disease is often insidious, and the symptoms are vague or even absent. The main symptoms are persistent or paroxysmal dull pain or distension in the abdomen, accompanied by low fever, nausea, vomiting, abdominal distension, loss of appetite, etc. The abdominal pain of this disease may be intermittent, and the treatment of anti-infection, anti-tuberculosis and antispasmodic drugs is often ineffective. It has been reported that the proximal ureter and kidney are compressed or displaced, pyloric obstruction, gastric wall stiffness, duodenal notch or stenosis, duodenal loop enlargement and transverse colon displacement. Rare manifestations include leg swelling, chylous ascites, portal hypertension, biliary obstruction and fistula formation. Examination of the abdomen can touch a mass or localized fullness, with deep tenderness, no abdominal muscle tension, and active bowel sounds.

3. Treatment Methods

1. Drug treatment:

Antibacterial drugs or traditional Chinese medicine treatment are mainly given according to the nature of the infection. Tuberculosis patients should be given regular anti-tuberculosis treatment, but the course of treatment needs 1 to 2 years, and larger abscesses require drainage.

2. Surgical treatment:

For relatively localized lumps or those with compression of adjacent organs that are not responsive to non-surgical treatment, surgical resection can be used.