Sickle cell crises of the abdomen
These crises are characterised by severe abdominal pain with the signs of an acute abdomen; they are probably due to sequestration of sickled cells in the circulation of the gut.
Some common conditions seen frequently as acute abdominal pain in SCD includes:
- vaso-occlusion – in the mesenteric circulation
- cholelithiasis
- cholangitis
- mesenteric/colonic ischaemia
- hepatic infarction/abscess/sequestration
- intra-abdominal abscess
- splenic infarction
- renal or hepatic vein thrombosis (1)
Management of acute abdomen
- appropriate examinations should be carried out in patients who presents with an acute abdomen e.g. - blood cultures, serum amylase, abdominal ultrasound, abdominal X-ray and CT
- acute abdominal pain due to SCD is managed conservatively in most cases,
- early involvement of the surgical team should be considered
- laparascopic cholecystectomy is recommended for treatment of symptomatic gallstones (1).
Reference:
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