Unusual causes of abdominal pain: sickle cell anemia

Ahmed, Shahid; Shahid, Rabia; Russo, Linda

doi:10.1016/j.bpg.2004.11.007

Cited by 36 publications

(30 citation statements)

References 91 publications

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“…Severe, persistent elevations may relate to hepatic infarct, characterized by a wedge-shaped, hypointense CT lesions [83]. Hepatic abscess has been rarely reported, but should be suspected in a patient with fever, a course different from their usual sickle cell crisis, right upper quadrant pain, and tender hepatomegaly [84–88].…”

Section: Gastrointestinal/hepatobiliary Complicationsmentioning

confidence: 99%

Beyond the Definitions of the Phenotypic Complications of Sickle Cell Disease: An Update on Management

Ballas

Kesen

Goldberg

et al. 2012

The Scientific World Journal

147

144

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The sickle hemoglobin is an abnormal hemoglobin due to point mutation (GAG → GTG) in exon 1 of the β globin gene resulting in the substitution of glutamic acid by valine at position 6 of the β globin polypeptide chain. Although the molecular lesion is a single-point mutation, the sickle gene is pleiotropic in nature causing multiple phenotypic expressions that constitute the various complications of sickle cell disease in general and sickle cell anemia in particular. The disease itself is chronic in nature but many of its complications are acute such as the recurrent acute painful crises (its hallmark), acute chest syndrome, and priapism. These complications vary considerably among patients, in the same patient with time, among countries and with age and sex. To date, there is no well-established consensus among providers on the management of the complications of sickle cell disease due in part to lack of evidence and in part to differences in the experience of providers. It is the aim of this paper to review available current approaches to manage the major complications of sickle cell disease. We hope that this will establish another preliminary forum among providers that may eventually lead the way to better outcomes.

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Section: Gastrointestinal/hepatobiliary Complicationsmentioning

confidence: 99%

Beyond the Definitions of the Phenotypic Complications of Sickle Cell Disease: An Update on Management

Ballas

Kesen

Goldberg

et al. 2012

The Scientific World Journal

147

144

View full text Add to dashboard Cite

show abstract

“…Abdominal ultrasound scan should be performed to confirm biliary duct obstruction by a stone for which an elective cholecystectomy could be done, once the acute episode has subsided. Elective cholecystectomy is also indicated in patients with chronic abdominal pain in association with gallstones [30]. However, cholecystectomy in the presence of asymptomatic cholelithiasis remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Hepatobiliary Ultrasonographic Abnormalities in Adult Patients with Sickle Cell Anaemia in Steady State in Ile-Ife, Nigeria

et al. 2018

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SummaryBackgroundSickle cell anaemia (SCA) is associated with structural manifestations in the hepatobiliary axis. This study aimed to investigate the hepatobiliary ultrasonographic abnormalities in adult patients with sickle cell anaemia in steady state attending the Haematology clinic of a federal tertiary health institution in Ile-Ife, Nigeria.Material/MethodsBasic demographic data as well as right upper abdominal quadrant ultrasonography of 50 consecutive sickle cell anaemia patients were compared with those of 50 age- and sex-matched subjects with HbAA as controls.ResultsEach of the study groups (patients and controls) comprised of 21 (42%) males and 29 (58%) females. The age range of the patients was 18–45 years with a mean (±SD) of 27.6±7.607 years, while that of the controls was 21–43 years with a mean (±SD) of 28.0±5.079 years (p=0.746). Amongst the patients, 32 (64%) had hepatomegaly, 15 (30%) cholelithiasis and 3 (6%) biliary sludge. Fourteen (28%) of the patients had normal hepatobiliary ultrasound findings. In the control group, one (2%) person had cholelithiasis, one (2%) biliary sludge, one (2%) fatty liver and none hepatomegaly. Forty-seven (94%) of the controls had normal hepatobiliary ultrasound findings. There was a statistically significant difference in the prevalence of hepatomegaly and cholelithiasis between the patients and controls (p value <0.001 for both comparisons).ConclusionsIn this study, hepatomegaly, cholelithiasis and biliary sludge were the most common hepatobiliary ultrasound findings in patients with sickle cell anaemia. Ultrasonography is a useful tool for assessing hepatobiliary abnormalities in patients with sickle cell anaemia.

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“…These include hemosiderin pigment, periportal fibrosis, and distension of sinusoids with sickle cell. [14] These were, however, not assessed in this study.…”

Section: Discussionmentioning

confidence: 92%

Biochemical and ultrasound assessment of the liver in sickle cell anaemia patients in Zaria, Nigeria

et al. 2014

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A B S T R A C TIntroduction: Sickle cell anemia (SCA) is frequently associated with liver disease. The constant state of hemolysis due to reduced red cell survival; and multiple blood transfusions, places these patients at risk hepatic sinusoidal congestion, viral hepatitis, cholestasis, and hemosiderosis, all of which may contribute to the development of liver disease. Objective: The aim was to assess the pattern of biochemical liver function tests and their relationship with liver size in steady state adult SCA patients in Zaria, North-West, Nigeria. Materials and Methods: Seventy-one adult SCA patients in steady state and 20 hemoglobin AA controls were enrolled into the study. Liver function tests were carried out and liver spans assessed using B-mode ultrasound scan in all subjects. Results: The serum bilirubin, aspartate transaminase (AST) and AST/alanine transaminase (ALT) ratio were signifi cantly higher in SCA patients than in controls, with P values of 0.04, <0.001, and <0.001 respectively. Thirty-four (48%) SCA patients had AST/ALT ratio of >2. Hepatomegaly was present in 67/71 (94%) of the patients, and absent in the controls. The liver span was signifi cantly greater in SCA patients (P < 0.001). There were no signifi cant difference in the mean values of ALT, alkaline phosphatase (ALP), total protein and albumin. There was no correlation between the liver span and the biochemical parameters. Conclusion: Steady state SCA patients in Ahmadu Bello University Teaching Hospital, Zaria, have hepatomegaly associated with minimal elevation of ALT and ALP. There was no correlation between the liver span and the biochemical parameters. It is advisable that liver function tests and liver ultrasound scan be interpreted with caution in these patients.

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Unusual causes of abdominal pain: sickle cell anemia

Cited by 36 publications

References 91 publications

Beyond the Definitions of the Phenotypic Complications of Sickle Cell Disease: An Update on Management

Beyond the Definitions of the Phenotypic Complications of Sickle Cell Disease: An Update on Management

Hepatobiliary Ultrasonographic Abnormalities in Adult Patients with Sickle Cell Anaemia in Steady State in Ile-Ife, Nigeria

Biochemical and ultrasound assessment of the liver in sickle cell anaemia patients in Zaria, Nigeria

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