Mesenteric lymph nodes

Function

Up to 200 nodes escort the mesenteric vessels, filtering the gut's lymph — including the chylomicron-rich chyle that carries absorbed fat. They swell in mesenteric adenitis, the childhood mimic of appendicitis, and in inflammatory bowel disease's creeping fat.

The gut-associated lymphoid tissue they serve is the body's largest immune organ — tolerance to food, defence against pathogens, and the balance whose failure is inflammatory bowel disease.

Blood supply

Mesenteric arterial arcades.

Nerve supply

Autonomic fibres travel with the vessels.

Clinical relevance

Mesenteric adenitis

Viral inflammation of the nodes causes right lower quadrant pain — the child who looks too well for appendicitis but has the same story.

TB adenitis (abdominal)

Mycobacteria caseate the mesenteric nodes — the cold abdominal mass and the mimic of Crohn's.