Ischemic colitis complicating sickle cell crisis.

Area of Science:

• Gastroenterology
• Hematology
• Pathology

Background:

• Abdominal pain is a frequent yet poorly understood symptom during sickle cell crises.
• The exact etiology of abdominal pain in sickle cell disease (SCD) remains controversial.

Observation:

• An 18-year-old male with SCD presented with acute abdominal pain during a crisis.
• Physical examination revealed rebound tenderness, and barium enema showed "thumbprinting" suggestive of colon infarction.

Findings:

• Histopathologic examination of the resected ascending colon confirmed ischemic colitis, characterized by mucosal necrosis and submucosal edema.
• The findings support a link between sickle cell-induced vasocclusion and ischemic colitis.

Implications:

• This case underscores ischemic colitis as a potential cause of abdominal pain in sickle cell crisis.
• Understanding the pathophysiology of vasocclusion in SCD is crucial for diagnosing and managing abdominal complications.