Sonographic evaluation of abdominal organs in a sickle cell disease patient

Abstract

Background: SCD is one of the most common inherited hemoglobinopathies worldwide. It is a major health problem in Madhya Pradesh and surrounding states. The present study was undertaken to infer the value of ultrasonography in evaluating abdominal organs in a SCD patient. Study design: This is a prospective hospital based study. Method: 100 SCD patients were assessed for abdominal pathologies by USG, the results thus analyzed and prevalence was calculated. Result: Hepatomegaly is the most common association observed in 69% of patients followed by splenomegaly in 31% patients & increased renal size in 29% patients. Cholelithiasis (17%), increased renal medullary echogenecity (14%), Auto-splenectomy (11%), Bright liver (9%), Splenic calcification (8%), Increased GB wall thickness (6%), Splenic infarct (5%) and Increased pancreatic echogenicity (3%) are the other associated findings. Conclusion: Real time ultrasonography is a simple, cheap, rapid, easily accessible, non-invasive, non-ionizing screening procedure in all cases of SCD patient for assessment of pathological changes occurring in the various abdominal organs. The high rates of abdominal pathologies being diagnosed on ultrasonography underscores the need for it to be established as a standard screening procedure with established protocols.

Determinants of splenic preservation among patients with sickle cell disease in North‐Eastern Nigeria

“…The frequency of non-visualised spleens in our study was also similar to those reported in patients with SCD in Turkey (42.9%) [31] and the United States (35.7%) [32]. Lower frequencies have been found in Asia (11%) [33], the Middle-East (6.1%) [12] and the United States (9%) [21]. The variability of splenic nonvisualisation on ultrasonography in the different geographic location may partly be explained by the presence of genetic factors known to inhibit sickling, such as alphathalassaemia and HbF [11,20], improvement in clinical care and outcomes in SCD [21,32], and also environmental factors that results in the frequent exposure to organisms known to cause spleen enlargement including malaria and bacterial infections [34,35].…”

Ultrasonographic Splenic Indices Among Paediatric and Adults with Sickle Cell Disease in Nigeria

“…Whereas most studies used spleen length to define splenomegaly in SCD (10)(11)(12)(13)(14)(15)(16)(17)36), others used spleen volume (18,19,37,38) or both length and volume (31)(32)(33). Given the strong positive correlation between spleen length and volume in our normal controls (rho = 86.4; P = 0.0001), consistent with earlier reports (26,39), both parameters were used to classify spleen sizes.…”

“…Other diagnostic modalities used in the radiological assessment of the spleen include CT and MRI scan (7)(8)(9), however, routine use of CT or MRI imaging is not feasible in most developing countries because of high cost and limited availability. Despite the widespread use of ultrasonography in the clinical evaluation of splenic enlargement, there is no consensus on how to define splenomegaly among SCD patients, as various cut-off values have been used in the literature (10)(11)(12)(13). Some studies have considered a spleen length of 13 cm to indicate enlarged spleens (10,11,14,15), while others have defined splenic enlargement as a spleen length of > 11cm (12) or > 12 cm (13).…”

“…Despite the widespread use of ultrasonography in the clinical evaluation of splenic enlargement, there is no consensus on how to define splenomegaly among SCD patients, as various cut-off values have been used in the literature (10)(11)(12)(13). Some studies have considered a spleen length of 13 cm to indicate enlarged spleens (10,11,14,15), while others have defined splenic enlargement as a spleen length of > 11cm (12) or > 12 cm (13). Some authors have used spleen length to define splenomegaly (16,17), while others have used spleen volume (18,19).…”

Comparative sonographic assessment of the spleen in individuals with and without sickle cell anaemia in Abakaliki, Nigeria

“…echogenic foci in the studies by Gale et al and30 Kaushal et al may be due to difference in geographical locations, as their studies were carried out in the United states and India, respectively. In 24 addition, study conducted by Gale et al was a retrospective, three-year study, with inclusion of patients on treatment with hydroxyurea, which may also affect the splenic echopattern.…”