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[Splenic infarction at high altitude, Huaraz-Peru (3,100 masl)]

Douglas López de Guimaraes1, Julio Menacho López, Jovita Villanueva Palacios

  • 1Jefe del Departamento de Emergencia del Hospital VIctor RAmos Guardia de Huaraz, Universidad Nacional de Ancash, Perú.

Insights

High altitude can cause splenic infarction in healthy individuals. Prompt diagnosis and hemoglobin electrophoresis are crucial for identifying sickle cell trait carriers presenting with abdominal pain at high altitudes.

Area of Science:

  • Altitude Medicine
  • Hematology
  • Gastroenterology

Background:

  • Splenic infarction is a rare condition.
  • High altitude environments (>3000m) pose unique physiological challenges.
  • Sickle cell trait is a genetic condition affecting hemoglobin.

Observation:

  • Three cases of splenic infarction in healthy men at high altitude (Huaraz, 3100m) are presented.
  • Patients experienced sudden onset of acute abdominal pain, nausea, vomiting, and abdominal distension.
  • Clinical and radiological findings indicated splenic enlargement and infarction.

Findings:

  • One patient was diagnosed with heterozygous sickle cell trait (Hb S: 38.5%) after presenting with splenic infarction.
  • Two other patients, without a history of hemoglobinopathy, also presented with symptoms suggestive of splenic infarction at high altitude.
  • Hemoglobin electrophoresis was recommended for all cases to rule out underlying sickle cell trait.

Implications:

  • Clinicians should consider splenic infarction in healthy individuals experiencing acute abdominal pain at high altitudes.
  • Early diagnosis and identification of sickle cell trait are critical for managing patients at high altitudes.
  • This highlights the importance of screening for sickle cell trait in individuals presenting with splenic infarction in high-altitude regions.
Abstract

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