Sonographic Assessment of Some Abdominal Organs in Children with Sickle Cell Disease in Ilorin, Nigeria

Abstract

Background: The irregular sickle cells can block blood vessels, causing tissue and organ damage and in most cases presented with pain as a result of organ ischemia. Ultrasonography is an easily available instrument for investigating abdominal organs which are most commonly affected by sickle cell disease (SCD). This study was aimed to assessing liver, gall bladder, spleen, and kidney in children with SCD in Ilorin, Kwara State. Methods: A prospective cross-sectional study was conducted among children with SCD in Ilorin from September 2017 to April 2018. An ethical approval was obtained from the Human Research and Ethics Committee of the Kwara State Ministry of Health. In this study, 106 children with SCD and 106 normal children for control were included. Abdominal ultrasound scan was performed on all the selected subjects and the findings were recorded on the data capture sheet. Descriptive and inferential statistic was used in the data analysis, SPSS version 20 was used and the P = 0.05. Results: In the children with SCD, hepatomegaly was found in 45 (42.5%), 29 (27.4%) had coarse echo pattern of liver and 16 (15.1%) had hyperechoic liver, 5 (4.7%) had gallbladder stone, 2 (1.9%) had gallbladder sludge, and 6 (5.6%) had thickened gallbladder wall. Twenty-five (23.6%) had splenomegaly, and 7 (6.6%) had autosplenectomy. Four (3.8%) showed reduced corticomedullary differentiation in each kidney, five (4.7%) in each kidney had mild calyceal dilatation. One (0.9%) had mild calyceal dilatation with reduced corticomedullary differentiation with accompanying loss of renal sinus fat. Conclusion: Abdominal ultrasound imaging for patients with SCD showed a high incidence of abdominal abnormalities, especially in solid organs such as liver, kidney, and spleen.

Gastrointestinal symptoms, diagnostic evaluations, and abdominal pathology in children with sickle cell disease

“…While only a limited number of abdominal imaging was performed in our cohort (33% for abdominal radio- SCD in Turkey, Nigeria, and Greece, respectively. 28,30,31 In contrast to our study, which revealed gallbladder abnormalities as the most common abdominal US imaging abnormality, these studies showed hepatomegaly was the most common abnormality found on abdominal US. It is likely that the difference in their results and ours could be because we evaluated imaging abnormalities only in patients with a complaint of abdominal pain.…”

“…Balci et al., Muftaudeen et al., and Papadaki et al. also reported high prevalence solid organ abnormalities on abdominal US in their patients with SCD in Turkey, Nigeria, and Greece, respectively 28,30,31 . In contrast to our study, which revealed gallbladder abnormalities as the most common abdominal US imaging abnormality, these studies showed hepatomegaly was the most common abnormality found on abdominal US.…”