Duodenal Ulcer in Sickle Cell Anemia

Department of Pediatrics, Cook County Hospital, Chicago, Illinois.
Journal of Pediatric Gastroenterology and Nutrition (Impact Factor: 2.63). 02/1990; 10(1):117-20. DOI: 10.1097/00005176-199001000-00023
Source: PubMed


A 14-year-old black male with sickle cell anemia developed a duodenal ulcer that masqueraded as sickle cell-related abdominal pain crisis on multiple occasions. Malingering and poor therapeutic compliance aggravated the ulcer in this patient, who ultimately succumbed to a catastrophic bleed. Duodenal ulcer appears to be an infrequent but difficult to treat lesion in sickle cell disease. An in-depth review on the occurrence of duodenal ulcer in sickle cell anemia is presented. The etiological mechanisms of peptic ulcer disease in this population and the potential benefits of transfusion therapy are discussed.

1 Follower
6 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A case of pancreatitis that occurred as a complication of a vaso-occlusive crisis in a child with sickle cell anemia is reported. We encourage others to consider pancreatitis as a cause for abdominal pain in children with multisystem diseases, particularly those that may cause ischemic organ injury such as sickle cell anemia.
    Preview · Article · Feb 1993 · Journal of the National Medical Association
  • [Show abstract] [Hide abstract]
    ABSTRACT: The literature was reviewed to investigate the existence of unique gastrointestinal (GI) pathological lesions in sickle-cell disease (SCD). Chole- and choledocholithiasis have long been recognized, but bilirubin gallstones can occur in any chronic hemolytic anemia. Acute pancreatitis has been reported as a possible ischemic consequence of sickling. It is unclear if the hepatic lesions of SCD differ from those of any chronically transfused population. Hepatic failure has been associated with massive sickling and hyperviscous bile ("sludge") has been linked to SCD. Elevated 5'-nucleotidase in the presence of elevated aminotransferase may suggest both hepatic and biliary tree involvement in a subgroup of patients with SCD. Low levels of the hepatically produced coagulation inhibitors, Protein S and Protein C, have been identified in SCD, but their precise relation to thrombosis in this instance remains unclear. Finally, a syndrome of intracanalicular cholestasis, sinusoidal dilation. Kupffer cell hyperplasia, and erythrophagocytosis has been linked to SCD. It has been suggested that the use of exchange transfusion prior to liver biopsy in this group of pediatric SCD patients may mask the pathophysiological role of sickled red blood cells in hepatic dysfunction. With the exception of some of the situations cited, it is concluded that most GI lesions in SCD are common to a heavily transfused population with chronic hemolytic anemia.
    No preview · Article · Jan 1998 · Annals of clinical and laboratory science
  • [Show abstract] [Hide abstract]
    ABSTRACT: Sickle cell disease (SCD) is a common genetic disorder which represents a major medical problem in certain parts of the world. It is characterized by chronic haemolytic anaemia and vaso-occlusive crises, which can lead to widespread vascular occlusion by sickled red blood cells leading to multiple organ infarctions. In this respect, SCD can be considered as a multisystem disease presenting, to various surgical disciplines, a wide variety of surgical ailments. As surgical management of these patients is associated with high morbidity and mortality, close collaboration between medical and surgical services is essential. Greater population mobility makes recognition of the surgical implications of this disease of paramount importance in surgical practice. This article reviews surgical problems with which SCD patients may present to general surgeons and discusses their management.
    No preview · Article · May 1998 · Journal of the Royal College of Surgeons of Edinburgh
Show more