Acute abdominal pain in sickle cell disease

Abstract EN

A prospective study of paediatric patients with sickle cell disease (SCD) admitted to Qateef Central Hospital (QCH) because of abdominal pain was carried out between July 1990 and October 1992.

Out of 59 admissions, 53 had acute abdominal painful crises (APC) and 6 patients had acute surgical abdomen (ASA).

History of abdominal pain was found in 66% of APC.

Vomiting was found in 66.7% of ASA and 26% of APC.

Diffuse abdominal pain was found in all ASA and 11.3% of APC.

Rigidity, involuntary guarding and decreased bowel sounds were found in 66.7 % of ASA and 9.4% of APC.

Rebound renderness and increased bowel sounds were found only in ASA (33.4 %).

Accompanying painful bone crises was found in 56.6% of APC and in 33.3% of ASA.

Past history of abdominal pain, diffuse abdominal pain and accompanying painful bone crises were features of APC.

On the other hand, signs of peritoneal irritation were features of ASA.

Sickle cell disease (SCD) is one of the commonly inherited disorders in the Eastern Province of S audi Arabia1, and has variable clinical course.

Acute abdominal pain is one of the common problems in patients with SCD which has been known since the early description of Washburn2.

At Qateef Central Hospital 10.7% of paediatric patient admissions with SCD were due to acute abdominal pain (unpublished data).

The differentiation of this pain from acute surgical abdomen remains a challenging clinical problem for both the paediatrician and the paediatric surgeon.

This difficulty is further complicated by the administration of narcotic medications which may mask the progression of signs and symptoms of acute surgical abdomen.

The aim of this study is to delineate the pattern of clinical features, causes, and course of paediatric patients with SCD presenting with acute abdominal pain and analyse this in relation to clinical and laboratory variables.