Cholelithiasis: A differential diagnosis in abdominal 'crisis' of sickle cell anemia

Journal of the National Medical Association (Impact Factor: 0.96). 04/1981; 73(3):271-3.
Source: PubMed


A review of the most recent literature on biliary tract disease in sickle cell (HbSS) disease has shown gallstones to be present in approximately 67 percent of affected patients. There is adequate evidence to urge all physicians to be aware of the contributions of gall bladder disease to the abdominal symptoms of sickle cell anemia. Frequently, because it is difficult to distinguish between the painful "crises" and gall bladder disease, the latter diagnosis is not considered.This article submits that investigative procedures of the gall bladder, in all patients with HbSS disease and abdominal crises, should be performed. If gallstones are present, elective cholecystectomy in the adequately prepared patient seems to be justified.

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    ABSTRACT: Gallstones are frequently found in patients with sickle cell anemia. The differentiation between acute calculous biliary tract disease and sickle cell crisis can be difficult and should be based on the clinical presentation, comparison with previous episodes of abdominal pain, and judicious use of hepatobiliary radionuclide scanning. Emergency cholecystectomy is associated with a high morbidity and should be avoided if possible. Elective cholecystectomy is associated with a lower but still significant risk of complications. We believe patients with sickle cell anemia and symptomatic cholelithiasis should have elective cholecystectomy. Careful management is essential to minimize the danger of postoperative complications.
    No preview · Article · Feb 1986 · Southern Medical Journal
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    ABSTRACT: Infection is the most common cause of high morbidity, hospitalization, and mortality in children with sickle cell anemia. In this study of pediatric sickle cell anemia patients, aged 1 to 19, we explore the hypothesis that gallstones (usually pigment stones) create a nidus of infection, predisposing the affected patients to high morbidity. Our study involved 86 children with sickle cell anemia at the Howard University Center for Sickle Cell Disease, who had been followed at the clinic for a total of 602 patient years. Review of their records revealed that patients with gallstones had a mean number of 10.24 hospitalizations and 25.35 ambulatory visits; those without gallstones had a mean number of only 4.26 hospitalizations and 13.41 ambulatory visits. In children with sickle cell anemia and gallstones, elective cholecystectomy (or, in the future, cholelithotripsy) could reduce the high morbidity caused by infection.
    Preview · Article · Oct 1990 · Journal of the National Medical Association