Abdominal Pain in Children With Sickle Cell Disease

Abstract

The differential diagnosis of abdominal pain is broad in any child, and further complicated in children with sickle cell disease (SCD). Acute causes of abdominal pain may require emergent surgery, such as for appendicitis or obstruction caused by a bezoar. Rapid intervention is necessary and life-saving in children with SCD and acute splenic or hepatic sequestration. The majority of children with SCD presenting to the physician's office or emergency department will have subacute reasons for their abdominal pain, including but not limited to constipation, urinary tract infection, peptic ulcer disease, and cholecystitis. Vaso-occlusive pain often presents in children as abdominal pain, but is a diagnosis of exclusion. The case of a 10-year-old girl with intermittent abdominal pain is used as a starting point to review the pathophysiology, diagnosis, and treatment of the most acute and common causes of abdominal pain in children with SCD.

Clinical, hematological and genetic data of a cohort of children with hemoglobin SD

“…During the crises, these children are generally assumed to have Hb S/D-Punjab even if they have not been submitted to molecular testing. Pain crises may be difficult to distinguish from other equally prevalent etiologies in children such as constipation and functional abdominal pain 26 . It is known that abdominal pain affects 38% of the school-aged pediatric population weekly; no reliable biological markers clearly define a diagnosis of functional pain 27 .…”

Diseases of the gallbladder in children — modern view of pediatric surgeon (systematic review)

“…№ 1 шают риск осложнений заболевания. Поэтому рекомендуется, чтобы подготовка больных серповидноклеточной анемией к предстоящей операции удаления желчного пузыря основывалась на адекватной гидратации и переливании крови до приемлемого уровня гемоглобина, составляющего не ниже 10 мг/дл [16]. Недавний ретроспективный обзор литературы показал, что плановая холецистэктомия при желчнокаменной болезни у педиатрических пациентов с серповидноклеточной анемией снижает риск осложнений по сравнению с детьми, перенесшими неотложную операцию [17].…”

Acute Appendicitis in Pediatric Patients With Sickle Cell Disease: Lower Incidence, More Imaging, and More False-Positives

“…Sickle-cell disease (SCD) is associated with several complications that may cause abdominal pain including vasoocclusive crisis (VOC), splenic and hepatic sequestration, cholecystitis, pyelonephritis, and renal infarction [1,2]. VOC is a distinguishing clinical feature of SCD [1,3] and is the leading cause of hospital visits in affected patients [4,5].…”

“…VOC may cause pain anywhere in the body including the abdomen [2,9]. When pain localizes to the right lower quadrant (RLQ), appendicitis may be considered.…”