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Abdominal pain in children with sickle cell disease

Melissa M Rhodes1, David Gregory Bates, Tina Andrews

  • 1*Nationwide Children's Hospital †Department of Pediatrics, The Ohio State University, Columbus, OH.

Journal of Clinical Gastroenterology
|November 20, 2013
PubMed

Insights

Diagnosing abdominal pain in children with sickle cell disease (SCD) requires careful consideration of acute surgical emergencies and common subacute causes. Prompt evaluation is crucial for life-saving interventions in SCD patients experiencing severe pain episodes.

Area of Science:

  • Pediatric Hematology
  • Gastroenterology
  • Emergency Medicine

Background:

  • Abdominal pain in children presents a broad differential diagnosis.
  • Sickle cell disease (SCD) significantly complicates the diagnostic process for abdominal pain in pediatric patients.
  • Acute abdominal conditions in children can necessitate emergent surgical intervention.

Observation:

  • Children with SCD face unique challenges in diagnosing abdominal pain.
  • Acute splenic or hepatic sequestration in SCD requires rapid, life-saving intervention.
  • Common causes of abdominal pain in SCD include constipation, UTIs, peptic ulcer disease, and cholecystitis.
  • Vaso-occlusive pain, a common presentation in SCD, is a diagnosis of exclusion.

Findings:

  • The differential diagnosis for abdominal pain in children with sickle cell disease is extensive.
  • Urgent surgical evaluation is critical for conditions like appendicitis or obstruction in pediatric SCD.
  • Subacute causes are more frequent, but acute events demand immediate attention.

Implications:

  • This review highlights the importance of a systematic approach to abdominal pain in pediatric SCD.
  • Early recognition and management of acute complications can improve patient outcomes.
  • Understanding the diverse causes of abdominal pain is vital for clinicians managing children with SCD.

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