Splenic Infarction in a Patient With Sickle Cell Trait Following High-Altitude Exposure

Sickle cell trait (SCT) is a generally asymptomatic carrier condition but clinical complications are recognized. Splenic infarction from exposure to high altitude is one complication of sickle cell trait. We report a 53-year-old man who traveled to Mammoth Lakes, California, and experienced an onset of abdominal pain approximately seven hours after arrival. In the local emergency department, the patient was diagnosed with presumed SCT using the sickle cell solubility test. Contrast-enhanced computed tomography (CECT) of the abdomen and pelvis obtained 12 hours after symptom onset was read as mild heterogenous enhancement of the spleen but without acute disease. After supportive care, the patient was discharged the next day with recommendations to descend immediately for presumed splenic syndrome. When his symptoms continued for days unabated, the patient presented to his primary care office, and repeat imaging performed 10 days later demonstrated a large splenic infarction. The patient recovered fully with supportive therapy and the diagnosis of SCT was confirmed by hemoglobin electrophoresis.